Provider Demographics
NPI:1174759351
Name:G. PERRIN UNDERWOOD, M.D. P.C.
Entity type:Organization
Organization Name:G. PERRIN UNDERWOOD, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:G PERRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-284-4106
Mailing Address - Street 1:2055 NORMANDIE DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-2732
Mailing Address - Country:US
Mailing Address - Phone:334-284-4106
Mailing Address - Fax:334-284-4486
Practice Address - Street 1:2055 NORMANDIE DR
Practice Address - Street 2:SUITE 212
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36111-2732
Practice Address - Country:US
Practice Address - Phone:334-284-4106
Practice Address - Fax:334-284-4486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11798207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty