Peterson, Brent P

Peterson, Brent P is an individual health care provider with primary practice located at 3336 N. Futrall Drive , Fayetteville AR 72703. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Peterson, Brent P can be contacted via phone (479) 463-3000.

Contact Information

Primary practice address
3336 N. Futrall Drive Fayetteville AR 72703
Phone: (479) 463-3000
Fax: (479) 463-3050
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 2003013356 Missouri
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X E-11020 Arkansas

Profile Details

NPI number 1427080894
LBN Legal business name Peterson, Brent P
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Jan 10th, 2019 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427080894 NPPES
Kansas MEDICAID 100641320A
Kansas Other P00046311
Kansas MEDICAID 209001809

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