MEDICARE: DR. ARTHUR DARWIN PETERSON D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2750	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	601496	OTHER	TX	MEDICARE PTAN

General Provider Information

NPI Number	:	1568472751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR DARWIN PETERSON D.C.

Provider Business Mailing Address
First Line	:	3933 SPICEWOOD SPRINGS RD
Second Line	:	SUITE E-400
City	:	AUSTIN
State	:	TX
Zip	:	78759-8761
Country	:	US
Telephone Number	:	512-338-8808
Fax Number	:	512-338-8815

Provider Business Practice Location Address
First Line	:	3933 SPICEWOOD SPRINGS RD
Second Line	:	SUITE E-400
City	:	AUSTIN
State	:	TX
Zip	:	78759-8761
Country	:	US
Telephone Number	:	512-338-8808
Fax Number	:	512-338-8815

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	02/22/2016

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