Basic Information
| Provider Information | |||||||||
| NPI: | 1285726505 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERRRINE | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | DIXON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 205 RIDGEWAY RD | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405021917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592680306 | ||||||||
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| Practice Location | |||||||||
| Address1: | UNIVERSITY HEALTH SERVICE | ||||||||
| Address2: | B 163 KENTUCKY CLINIC | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360284 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593235823 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0000X | 14035 | KY | X | Allopathic & Osteopathic Physicians | Family Medicine | Adolescent Medicine | 207QA0505X | 14035 | KY | X | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine |
No ID Information.