person
John J Petersen, PA
Surgical Physician Assistant in Medford, Oregon
NPI 1164580429

John J Petersen is a Surgical Physician Assistant based in Medford, OR and is specialized in Surgical. John J Petersen practices in Medford, OR and has the professional credentials of PA. The NPI Number for John J Petersen is 1164580429 and holds a License No. PA00228 (Oregon).

The current practice location address for John J Petersen is 520 Medical Center Dr, Medford, OR and can be reached out via phone at 541-789-5710.

Location: 520 Medical Center Dr, Medford, OR, 97504-8344
person
Provider Profile Details
NPI Number
1164580429
Provider Name
John J Petersen
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
520 Medical Center Dr, Medford, OR, 97504-8344
Phone Number
541-789-5710
Fax Number
Provider Enumeration Date
12/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500613512 05 OR
institution
Provider Business Practice Location Address Details
Address
520 Medical Center Dr
City
State
Zip
97504-4334
Phone Number
541-789-5710
Fax Number
person
Provider Business Mailing Address Details
Address
520 Medical Center Dr
City
State
Zip
97504-4334
Phone Number
541-789-5710
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA00228 (Oregon)
Definition
Definition to come...
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