Doctor Name: | DR. GUY ALAN PETERSEN |
NPI Number: | 1346638939 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 22232 |
Business Practice Address: | 5240 E Knight Dr Suite 100 Tucson, AZ - 857122122 |
Business Phone Number: | 5205829399 |
Business Fax Number: | |
Mailing Address: | 5240 E Knight Dr, Suite 100 TUCSON |
State: | AZ |
Postal Code: | 857122122 |
Phone Number: | 5205829399 |
Fax Number: | |
NPI Enumeration Date: | 01/05/2015 |
NPI Last Update Date: | 01/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 22232 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |