Peterson, Mark Delano

Peterson, Mark Delano is an individual health care provider with primary practice located at 1311 E Barnett Rd Ste 201, Medford OR 97504-8225. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, which is considered as his primary health care specialty. Peterson, Mark Delano can be contacted via phone (541) 779-5007.

Contact Information

Primary practice address
1311 E Barnett Rd Ste 201 Medford OR 97504-8225
Phone: (541) 779-5007
Fax: (541) 779-5022
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X MD18861 Oregon

Profile Details

NPI number 1699763607
LBN Legal business name Peterson, Mark Delano
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Sep 17th, 2013 - about 13 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 1699763607 NPPES
Oregon MEDICAID 128129

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