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General NPI Number Information
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NPI Number | 1417957234
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Entity Type | Individual
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Provider Name | JOHN L PETERSON MD
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Gender | Male
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 2406 CENTURY PLACE
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City | HICKORY
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State | NC
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Zip | 28603
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Country | US
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Telephone | 828-324-9550
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Fax | 828-324-4154
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Provider Business Mailing Address
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Address Line | PO BOX 3710
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City | HICKORY
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State | NC
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Zip | 28603-3710
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Country | US
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Telephone | 828-324-9550
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Fax | 828-324-4154
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 15487
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 042-0012323
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 38166
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License Number State | NC
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