# RAY E PETERS DO INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033536974
- **Authorized official:** SANDY SCHRACK (CREDENTIALING)
- **Authorized official phone:** (208) 664-4026

## Contact information

- **Practice address:** 221 PHYSICIANS PARK, POPLAR BLUFF, MO 63901-3956
- **Practice address phone:** (573) 778-9422
- **Practice address fax:** (573) 778-9963
- **Mailing address:** PO BOX 996, HAYDEN, ID 83835-0996
- **Mailing address phone:** (208) 664-4026
- **Mailing address fax:** (855) 532-5921

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | R2C32 | MO | Yes |

## Other

- **Enumeration date:** 03/27/2014
- **Last updated:** 03/27/2014