| Organization Name: | DR TIMOTHY PETERS |
| NPI Number: | 1154510998 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIMOTHY ROY PETERS (OWNER) |
| Mailing Address: | 605 Welch St Silverton |
| State: | OR US |
| Postal Code: | 973811946 |
| Phone Number: | 5038736987 |
| Fax Number: | 5038738923 |
| NPI Enumeration Date: | 10/17/2007 |
| NPI Last Update Date: | 10/17/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | MD17287 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |