Peterson, Jeffry Raymond
Peterson, Jeffry Raymond is an individual health care provider with primary practice located at 116 E 11Th St Suite 101, Spencer IA 51301-4364. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Peterson, Jeffry Raymond can be contacted via phone (712) 264-3500.Contact Information
Primary practice address
116 E 11Th St Suite 101
Spencer IA 51301-4364
Phone: (712) 264-3500
Fax: (712) 264-3535
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01768 | Iowa |
Profile Details
| NPI number | 1730169962 |
|---|---|
| LBN Legal business name | Peterson, Jeffry Raymond |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2006 |
| Last updated | Feb 10th, 2014 - about 11 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 | 1730169962 | NPPES |
| Iowa | MEDICAID | 3196287 |
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