Petersen, John J
Petersen, John J is an individual health care provider with primary practice located at 520 Medical Center Dr Suite 201, Medford OR 97504-4334. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Petersen, John J can be contacted via phone (541) 789-5710.Contact Information
Primary practice address
520 Medical Center Dr Suite 201
Medford OR 97504-4334
Phone: (541) 789-5710
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA00228 | Oregon |
Profile Details
| NPI number | 1164580429 |
|---|---|
| LBN Legal business name | Petersen, John J |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 5th, 2006 |
| Last updated | Jan 16th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164580429 | NPPES |
| Oregon | MEDICAID | 500613512 |
Popular Providers
-
Dorshorst, Robert David
2825 E Barnett Rd , Medford OR 97504-8332 -
Bone, Clarence Collin
2825 E Barnett Rd , Medford OR 97504-8332 -
Parker, Jose James
2900 State St , Medford OR 97504-8475 -
Tyndall, Kevin J
940 Royal Ave Suite 420, Medford OR 97504-6193 -
Aulakh, Kiran K
2780 E Barnett Rd Ste 200 , Medford OR 97504-8674 -
Francom, Jessica
2780 E Barnett Rd Ste 200 , Medford OR 97504-8674 -
Cook, Stephani Kathleen
520 Medical Center Dr Suite 300, Medford OR 97504-4334 -
Coats, Abby Lee
1333 E Barnett Rd , Medford OR 97504-8219