Peterson, Randy J

Peterson, Randy J is an individual health care provider with primary practice located at 1527 Broadway St , Alexandria MN 56308-2537. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Peterson, Randy J can be contacted via phone (320) 762-0399.

Contact Information

Primary practice address
1527 Broadway St Alexandria MN 56308-2537
Phone: (320) 762-0399
Fax: (320) 762-6847
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 32212 Minnesota
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 32212 Minnesota

Profile Details

NPI number 1235109430
LBN Legal business name Peterson, Randy J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Jan 17th, 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1235109430 NPPES
Minnesota Other 107120D277 UCARE
Minnesota Other 33Y08PE UCARE
Minnesota Other HP27225 UCARE
Minnesota Other 0104802 UCARE
Minnesota Other 1006215 UCARE
Minnesota MEDICAID 687892000 UCARE
Minnesota Other A006 UCARE
Minnesota Other 21468 UCARE

Popular Providers