Provider Demographics
NPI:1902061542
Name:JUSTICE, PERRY LANCE (DO)
Entity type:Individual
Prefix:DR
First Name:PERRY
Middle Name:LANCE
Last Name:JUSTICE
Suffix:
Gender:
Credentials:DO
Other - Prefix:DR
Other - First Name:LANCE
Other - Middle Name:
Other - Last Name:JUSTICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 2895
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056-2895
Mailing Address - Country:US
Mailing Address - Phone:256-735-5277
Mailing Address - Fax:
Practice Address - Street 1:1948 AL HIGHWAY 157
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0642
Practice Address - Country:US
Practice Address - Phone:256-735-5125
Practice Address - Fax:256-962-5446
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4652207V00000X
ALDO.1174207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology