DR. KEVIN WILLIAM PETERSON M.D. NPI 1790754877

NPI Information

DR. Kevin William Peterson, M.D. is a family medicine in Jacksonville, FL. 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. Kevin William Peterson, M.D. NPI is 1790754877. 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:

2377 DUNN AVE
UFJP DUNN AVENUE FAMILY PRACTICE CENTER
JACKSONVILLE, FL
ZIP 32218-983
Phone: (904) 633-0700
Fax: (904) 633-0701

The NPI 1790754877 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 3/14/2006 and was last updated on 4/22/2009.

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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