Peterson, Craig A

Peterson, Craig A is an individual health care provider with primary practice located at 1229 E Seminole St , Springfield MO 65804-2227. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Peterson, Craig A can be contacted via phone (417) 820-9393.

Contact Information

Primary practice address
1229 E Seminole St Springfield MO 65804-2227
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X R7E36 Missouri

Profile Details

NPI number 1396888640
LBN Legal business name Peterson, Craig A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2007
Last updated Oct 18th, 2011 - about 15 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 1396888640 NPPES
Missouri MEDICAID 202118733
Missouri Other 81582
Missouri Other 22698
Missouri MEDICAID 111851001

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