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General NPI Number Information
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NPI Number | 1730497348
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Entity Type | Individual
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Provider Name | JOSHUA SCOTT PETERS PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1830 BLAKE AVE SUITE 206
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City | GLENWOOD SPGS
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State | CO
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Zip | 81601-4275
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Country | US
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Telephone | 970-384-7140
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Fax | 970-945-0563
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Provider Business Mailing Address
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Address Line | PO BOX 5105
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City | BELFAST
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State | ME
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Zip | 04915-5100
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Country | US
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Telephone | 910-790-9714
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Fax | 910-791-1063
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | PA0004114
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA0004114
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-15379
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License Number State | NC
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