Provider Demographics
NPI:1992929624
Name:PERRIN, ALLISON LEIGH (MD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LEIGH
Last Name:PERRIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E WILLETTA ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2727
Mailing Address - Country:US
Mailing Address - Phone:602-839-6900
Mailing Address - Fax:602-839-6906
Practice Address - Street 1:901 E WILLETTA ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2727
Practice Address - Country:US
Practice Address - Phone:602-839-6900
Practice Address - Fax:602-839-6906
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25790207RG0300X, 207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0887750OtherBLUE CROSS BLUE SHIELD
AZG71878Medicare UPIN
AZ71138Medicare ID - Type Unspecified