Jack T Peterson is a Specialist in Topeka, Kansas. Jack T Peterson practices all healthcare services and medical treatments related to Specialist. The NPI Number for Jack T Peterson is 1508860487. The last update date is 2012-04-24.
Jack T Peterson's current location address is 631 Sw Horne St, Topeka, Kansas. You can contact this provider via phone number 7852349000 and fax number 7852349119. The mailing address for Jack T Peterson is 631 Sw Horne St, Topeka, Kansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack T Peterson |
|---|---|
| Address | 631 Sw Horne St, Topeka, Kansas |
| Phone Number | 7852349000 |
| Fax Number | 7852349119 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1508860487 |
|---|---|
| Provider Enumeration Date | 2005-06-09 |
| Last Updated Date | 2012-04-24 |
Provider Mailing Address Detail
| Address | 631 Sw Horne St |
|---|---|
| City | Topeka |
| State | Kansas (KS) |
| Post Code | 6660616610 |
| Phone Number | 7852349000 |
| Fax Number | 7852349119 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 422259 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 240007246 | KS | RAILROAD MEDICARE | |
| 100516 | KS | BLUE CROSS | |
| 100144860B | KS | -- | |
| 628770 | KS | FIRST GUARD | |
| 481191346 | KS | TAX ID |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Jack T Peterson by the Centers for Medicare & Medicaid Services?
The Jack T Peterson has been assigned the NPI (National Provider Identifier) 1508860487 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Jack T Peterson?
The Jack T Peterson is situated at 631 Sw Horne St, in the city of Topeka, state of KS, with the zip code 6660616610.
What is Jack T Peterson's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Jack T Peterson is Specialist, and the taxonomy code that categorizes this field of expertise is 174400000X.
When did Jack T Peterson receive its 1508860487 assignment?
The Jack T Peterson was assigned its 1508860487 on 2005-06-09, which is the date when this unique identifier was issued to the organization.
When was the Jack T Peterson's information last updated?
The Jack T Peterson's information was last updated on 2012-04-24.
NPI Number: 1528061710
Address: 19 Nh Route 104, Meredith, NH