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Joseph R. Petersen, M.d.
Specialist in Burley, Idaho
NPI 1790956514

Joseph R. Petersen, M.d. is a Specialist based in Burley, ID. Joseph R. Petersen, M.d. practices in Burley, ID. The NPI Number for Joseph R. Petersen, M.d. is 1790956514 and holds a License No. M5283 (Idaho).

The current practice location address for Joseph R. Petersen, M.d. is 1344 Hiland Ave Ste A, Burley, ID and can be reached out via phone at 208-678-1138 and via fax at 208-678-5833.

Location: 1344 Hiland Ave Ste A, Burley, ID, 83318-1564
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1790956514
Provider Name
Joseph R. Petersen, M.d.
Credential
Provider Entity Type
Organization
Address
1344 Hiland Ave Ste A, Burley, ID, 83318-1564
Phone Number
208-678-1138
Fax Number
208-678-5833
Provider Enumeration Date
03/19/2008
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
1225105604 01 NPI INDIV
institution
Provider Business Practice Location Address Details
Address
1344 Hiland Ave Ste A
City
Burley
State
Idaho
Zip
83318-1564
Phone Number
208-678-1138
Fax Number
208-678-5833
person
Provider Business Mailing Address Details
Address
1344 Hiland Ave Ste A
City
Burley
State
Idaho
Zip
83318-1564
Phone Number
208-678-1138
Fax Number
208-678-5833
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
M5283 (Idaho)
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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