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Contact Information

PERRY KIDS PEDIATRICS
210 HOSPITAL LN
PERRYVILLE, MO63775-1276
 Phone: 573-517-0999
 Fax: 573-517-0812
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical Toxicology

2080T0002X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PERRY KIDS PEDIATRICS · (Female)

NPI Number 1417123761
Status Active
Credentials
Entity Individual
Enumeration date 05/07/2008
Last updated 05/07/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • MO License # MO105937
  • MO Medicaid 599297306
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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