Provider Demographics
NPI:1487709044
Name:PERRY, ROBERT TYRRELL (MD MPH)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TYRRELL
Last Name:PERRY
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 CLIFTON RD NE
Mailing Address - Street 2:MAILSTOP E05
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30333
Mailing Address - Country:US
Mailing Address - Phone:404-639-8224
Mailing Address - Fax:
Practice Address - Street 1:1600 CLIFTON RD NE
Practice Address - Street 2:MAILSTOP E05
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30333
Practice Address - Country:US
Practice Address - Phone:404-639-8224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD44535208000000X
GA053312208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics