Organization
GILMAN PETERSON MD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILMAN P. PETERSON JR. M.D. (PRESIDENT)
(270) 651-8328
Entity
Organization
Contact information
Practice address
109 BRAVO BLVD, GLASGOW, KY 42141-3412
(270) 651-8328
Mailing address
PO BOX 694, GLASGOW, KY 42142-0694
(270) 651-8328
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20017
KY
Other
Enumeration date
05/31/2007
Last updated
10/10/2012
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