Peterson, John Dale
Peterson, John Dale is an individual health care provider with primary practice located at 929 N Saint Francis St , Wichita KS 67214-3821. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Peterson, John Dale can be contacted via phone (800) 374-5326.Contact Information
Primary practice address
929 N Saint Francis St
Wichita KS 67214-3821
Phone: (800) 374-5326
Fax: (800) 374-7656
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 0531672 | Kansas |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207LC0200X | 0531672 | Kansas |
Profile Details
| NPI number | 1023239753 |
|---|---|
| LBN Legal business name | Peterson, John Dale |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2007 |
| Last updated | Oct 31st, 2022 - about 2 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 | 1023239753 | NPPES |
| Kansas | MEDICAID | 200611100A | |
| Kansas | Other | P00727380 | |
| Kansas | MEDICAID | 200611100B |
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