Peterson, Randall Watson
Peterson, Randall Watson is an sole proprietor health care provider with primary practice located at 3952 Teays Valley Rd , Hurricane WV 25526-8728. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Peterson, Randall Watson can be contacted via phone (304) 757-6736.Contact Information
Primary practice address
3952 Teays Valley Rd
Hurricane WV 25526-8728
Phone: (304) 757-6736
Fax: (304) 757-0582
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 14044 | West Virginia |
Profile Details
| NPI number | 1184694739 |
|---|---|
| LBN Legal business name | Peterson, Randall Watson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 25th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 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 | 1184694739 | NPPES |
| West Virginia | MEDICAID | 0057148000 |
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