PETERSEN CLINIC PLLC NPI 1235169384

NPI Information

  • NPI: 1235169384
  • Provider Name: PETERSEN CLINIC, PLLC
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • CLIA Number: 51D0235420
  • Address: 119 MAIN ST W
    SUITE A
    OAK HILL, WV
    ZIP 25901
  • Phone: (304) 465-0544

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NPI Details

PETERSEN CLINIC, PLLC is an internal medicine in Oak Hill, WV. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PETERSEN CLINIC, PLLC NPI is 1235169384. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

119 MAIN ST W
SUITE A
OAK HILL, WV
ZIP 25901-943
Phone: (304) 465-0544
Fax: (304) 465-8832

The provider's authorized official is Bruce N. Petersen .
The authorized official title is Co-owner and has the following contact phone number (304) 465-0544.

The CLIA number assigned to this NPI record is 51D0235420 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/4/2006 and was last updated on 9/11/2025.

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
1207Q00000XFamily Medicine942WEST VIRGINIANo
2207Q00000XFamily Medicine1864WEST VIRGINIANo
3207R00000XInternal Medicine941WEST VIRGINIAYes

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
10084786001MEDICAIDWEST 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: 11/21/2025

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