Peterson, Jack T

Peterson, Jack T is an sole proprietor health care provider with primary practice located at 631 Sw Horne St Ste 400, Topeka KS 66606-1661. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Peterson, Jack T can be contacted via phone (785) 234-9000.

Contact Information

Primary practice address
631 Sw Horne St Ste 400 Topeka KS 66606-1661
Phone: (785) 234-9000
Fax: (785) 234-9119
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0422259 Kansas

Profile Details

NPI number 1508860487
LBN Legal business name Peterson, Jack T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 9th, 2005
Last updated Apr 24th, 2012 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508860487 NPPES
Kansas Other 240007246 RAILROAD MEDICARE
Kansas Other 100516 RAILROAD MEDICARE
Kansas MEDICAID 100144860B RAILROAD MEDICARE
Kansas Other 628770 RAILROAD MEDICARE
Kansas Other 481191346 RAILROAD MEDICARE

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