Organization · Type 2 NPI
Joseph R. Petersen, M.d.
Specialist · Burley, ID
NPI number
1790956514
Active
Practice location
1344 Hiland Ave Ste A
Burley, ID 83318-1564
Fax (208) 678-5833
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | M5283 (ID) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
4 other providers at this address
Other specialist providers in Burley
About NPI 1790956514
Joseph R. Petersen, M.d.'s National Provider Identifier is 1790956514, issued on Mar 19, 2008. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Burley, ID. The record was last updated on Mar 19, 2008.