Peterson, Randolph E
Peterson, Randolph E is an sole proprietor health care provider with primary practice located at 840 Sw 4Th Ave , Ontario OR 97914-2627. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Peterson, Randolph E can be contacted via phone (541) 889-2899.Contact Information
Primary practice address
840 Sw 4Th Ave
Ontario OR 97914-2627
Phone: (541) 889-2899
Fax: (541) 889-2883
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 19969 | Oregon |
Profile Details
| NPI number | 1669461364 |
|---|---|
| LBN Legal business name | Peterson, Randolph E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 17th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1669461364 | NPPES |
| Oregon | MEDICAID | 135827 | |
| Oregon | Other | 838281001 | |
| Oregon | Other | 003426400 |
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