| Doctor Name: | TIMOTH Y JOHN PETERSON |
| NPI Number: | 1174668081 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 102006 |
| Business Practice Address: | St. Francis Healthcare Campus 2400 St. Francis Drive Breckenridge, MN - 56520 |
| Business Phone Number: | 2186430345 |
| Business Fax Number: | 2186430853 |
| Mailing Address: | 213 E Cecil Ave, FERGUS FALLS |
| State: | MN |
| Postal Code: | 565371416 |
| Phone Number: | 2187363507 |
| Fax Number: | |
| NPI Enumeration Date: | 02/20/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | 102006 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |