RANDALL WATSON PETERSON M.D. NPI 1184694739

NPI Information

NPI: 1184694739
Provider Name: RANDALL WATSON PETERSON, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
3952 TEAYS VALLEY RD
HURRICANE, WV
ZIP 25526
Phone: (304) 757-6736
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Randall Watson Peterson, M.D. is a family medicine in Hurricane, WV. 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. Randall Watson Peterson, M.D. NPI is 1184694739. 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:

3952 TEAYS VALLEY RD
HURRICANE, WV
ZIP 25526-728
Phone: (304) 757-6736
Fax: (304) 757-0582

The enumeration date for this NPI number is 1/25/2006 and was last updated on 7/9/2007.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		14044	WEST VIRGINIA	Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0553011	MEDICARE ID-TYPE UNSPECIFIED	WEST VIRGINIA	MEDICARE
2	0057148000	MEDICAID	WEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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