Basic Information
| Provider Information | |||||||||
| NPI: | 1740272079 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERLSON | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | HUGH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 NEWTOWN RD | ||||||||
| Address2: | WARMINSTER CAMPUS | ||||||||
| City: | WARMINSTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189745221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154416650 | ||||||||
| FaxNumber: | 2154416830 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 NEWTOWN RD | ||||||||
| Address2: | WARMINSTER CAMPUS | ||||||||
| City: | WARMINSTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189745221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154416650 | ||||||||
| FaxNumber: | 2154416830 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2005 | ||||||||
| LastUpdateDate: | 04/13/2018 | ||||||||
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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 | 207Q00000X | 0S003563L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0650936 | 05 | PA | MEDICAID |