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NPI Code Detail

MEDICARE: DR. JAMES ANDERS PETERSON PHARMD BCPS BCPP

MEDICARE:  DR. JAMES ANDERS PETERSON  PHARMD BCPS BCPP
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
11835P1200XPharmacotherapy Pharmacist9155AZ
21835P1200XPharmacotherapy Pharmacist0051-036224IL
31835P1300XPsychiatric Pharmacist9155AZ
41835P1300XPsychiatric Pharmacist0051-036224IL

General Provider Information

NPI Number : 1679695035
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES ANDERS PETERSON PHARMD BCPS BCPP
Provider Business Mailing Address
First Line : 5203 E CORONADO CIR
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-2336
Country : US
Telephone Number : 480-893-6908
Fax Number :
Provider Business Practice Location Address
First Line : 5203 E CORONADO CIRCLE
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-2336
Country : US
Telephone Number : 480-893-6908
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2007
Last Update Date : 08/30/2007

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Directions to “ DR. JAMES ANDERS PETERSON PHARMD BCPS BCPP” Practice Location

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