# GILMAN PETERSON MD PSC

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

## Provider details

- **NPI number:** 1053512483
- **Authorized official:** GILMAN P. PETERSON JR. M.D. (PRESIDENT)
- **Authorized official phone:** (270) 651-8328

## Contact information

- **Practice address:** 109 BRAVO BLVD, GLASGOW, KY 42141-3412
- **Practice address phone:** (270) 651-8328
- **Mailing address:** PO BOX 694, GLASGOW, KY 42142-0694
- **Mailing address phone:** (270) 651-8328

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 20017 | KY | Yes |

## Other

- **Enumeration date:** 05/31/2007
- **Last updated:** 10/10/2012