Provider Demographics
NPI:1205057072
Name:PERRY, LORING ISAAC (MD)
Entity type:Individual
Prefix:DR
First Name:LORING
Middle Name:ISAAC
Last Name:PERRY
Suffix:
Gender:M
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:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-0810
Mailing Address - Country:US
Mailing Address - Phone:603-308-1472
Mailing Address - Fax:
Practice Address - Street 1:4904 ASBURY LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3922
Practice Address - Country:US
Practice Address - Phone:301-312-4087
Practice Address - Fax:301-571-0089
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2023-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50046207Y00000X
NY183818207Y00000X
NHLT4394207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology