Peterson, Thomas L
Peterson, Thomas L is an individual health care provider with primary practice located at 1700 W Stout St , Rice Lake WI 54868-5000. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Medical Toxicology. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Peterson, Thomas L can be contacted via phone (715) 236-8100.Contact Information
Primary practice address
1700 W Stout St
Rice Lake WI 54868-5000
Phone: (715) 236-8100
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | WI26696 | Wisconsin |
Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | WI26696 | Wisconsin |
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 207PP0204X | WI26696 | Wisconsin |
Allopathic & Osteopathic Physicians / Medical Toxicology | 207PT0002X | WI26696 | Wisconsin |
Profile Details
NPI number | 1609820620 |
---|---|
LBN Legal business name | Peterson, Thomas L |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 22nd, 2006 |
Last updated | Feb 15th, 2010 - about 14 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 | 1609820620 | NPPES |
Wisconsin | MEDICAID | 30653800 |
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