DR. MARK GORDON PETERSON MD NPI 1629129168

NPI Information

DR. Mark Gordon Peterson, MD is a family medicine in Winslow, AZ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Mark Gordon Peterson, MD NPI is 1629129168. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

500 INDIANA AVE
WINSLOW, AZ
ZIP 86047-169
Phone: (928) 289-4646
Fax: (928) 289-6229

The NPI 1629129168 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/12/2007 and was last updated on 5/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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