Organization
STIG PEITERSEN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STIG E PEITERSEN MD PA (PHYSICIAN)
(936) 699-4730
Entity
Organization
Contact information
Practice address
1111 W FRANK AVE STE 302, LUFKIN, TX 75904-3323
(936) 699-4730
(936) 699-4737
Mailing address
1111 W FRANK AVE STE 302, LUFKIN, TX 75904-3323
(936) 699-4730
(936) 699-4737
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K0987
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141572101
—
TX
01
—
8429M0
BCBS
TX
Enumeration date
08/14/2007
Last updated
08/05/2010
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