Peterson, Jennifer S

Peterson, Jennifer S is an individual health care provider with primary practice located at 1204 Joseph St # 2 , Dodgeville WI 53533-9670. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Peterson, Jennifer S can be contacted via phone (608) 574-5044.

Contact Information

Primary practice address
1204 Joseph St # 2 Dodgeville WI 53533-9670
Phone: (608) 574-5044
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 41433-020 Wisconsin
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 41433-020 Wisconsin

Profile Details

NPI number 1700841178
LBN Legal business name Peterson, Jennifer S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Jan 7th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700841178 NPPES
Wisconsin Other 1040967 PHYSICIANS PLUS
Wisconsin MEDICAID 34220800 PHYSICIANS PLUS
Wisconsin Other 9990 PHYSICIANS PLUS

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