DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: PHILLIP H PETERSEN MD

MEDICARE: PHILLIP H PETERSEN MD
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
1207Q00000XFamily Medicine PhysicianM5405ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295730661
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP H PETERSEN MD
Provider Business Mailing Address
First Line : 301 CEDAR ST
Second Line :
City : OROFINO
State : ID
Zip : 83544-9029
Country : US
Telephone Number : 208-476-4555
Fax Number : 208-476-5385
Provider Business Practice Location Address
First Line : 301 CEDAR ST
Second Line :
City : OROFINO
State : ID
Zip : 83544-9029
Country : US
Telephone Number : 208-476-4555
Fax Number : 208-476-5385
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 12/19/2017

Similar Medicare Providers

1659376010 — PETER W CRECELIUS MD
Practice Location Address:
301 CEDAR ST
OROFINO, ID
83544-9029
Practice Phone: 208-476-4555
Practice Fax: 208-476-5385
1609871060 — KELLY MCGRATH MD
Practice Location Address:
301 CEDAR ST
OROFINO, ID
83544-9029
Practice Phone: 208-476-4555
Practice Fax: 208-476-5385
1972508497 — CHARITY D ROBINSON
Practice Location Address:
301 CEDAR ST
OROFINO, ID
83544-9029
Practice Phone: 208-476-4555
Practice Fax: 208-476-5385
1073551396 — CLEARWATER VALLEY HOSPITAL & CLINICS INC
Practice Location Address:
301 CEDAR ST
OROFINO, ID
83544-9029
Practice Phone: 208-476-4555
Practice Fax: 208-476-5385
1891733747 — CLEARWATER VALLEY HOSPITAL & CLINIC INC
Practice Location Address:
301 CEDAR ST
OROFINO, ID
83544-9029
Practice Phone: 208-476-4555
Practice Fax: 208-476-5385
1164463113 — BRETT T MUMFORD D.O.
Practice Location Address:
301 CEDAR ST
OROFINO, ID
83544-9029
Practice Phone: 208-476-5777
Practice Fax: 208-476-5385

Directions to “ PHILLIP H PETERSEN MD” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.