Petersen Clinic, Pllc
LBN: Petersen Clinic, Pllc
Petersen Clinic, Pllc is an health care organization with primary practice located at 119 Main St W Suite A, Oak Hill WV 25901-2943. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Petersen Clinic, Pllc can be contacted via phone (304) 465-0544, or through Petersen, Bruce N. via phone (304) 465-0544.
Contact Information
Primary practice address
119 Main St W Suite A
Oak Hill WV 25901-2943
Phone: (304) 465-0544
Fax: (304) 465-8832
Website:
Authorized official contact:
Name: Petersen, Bruce N. Doctor of Osteopathy (DO)
Phone: (304) 465-0544
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 942 | West Virginia |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 1864 | West Virginia |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 941 | West Virginia |
Profile Details
| NPI number | 1235169384 |
|---|---|
| LBN Legal business name | Petersen Clinic, Pllc |
| DBA Doing business as | |
| Authorized official | Petersen, Bruce N. Doctor of Osteopathy (DO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 4th, 2006 |
| Last updated | Aug 22nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235169384 | NPPES |
| West Virginia | MEDICAID | 0084786001 |
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