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General NPI Number Information
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NPI Number | 1568461747
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Entity Type | Individual
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Provider Name | ANTHONY G PETERS PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1101 9TH ST SE
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City | SIOUX CENTER
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State | IA
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Zip | 51250-2501
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Country | US
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Telephone | 712-722-2609
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Fax | 712-722-8426
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Provider Business Mailing Address
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Address Line | 1101 9TH ST SE
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City | SIOUX CENTER
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State | IA
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Zip | 51250-2501
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Country | US
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Telephone | 712-722-2609
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Fax | 712-722-8426
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0484
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 002094
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License Number State | IA
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