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Individual

DR. TIMOTHY JOHN PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3141 N 3RD AVE, SUITE 100, PHOENIX, AZ 85013-4351
(602) 331-5174
(602) 745-7950
Mailing address
2540 N AVENIDA SORGO, TUCSON, AZ 85749-8113
(520) 760-8895

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15942
AZ
207Q00000X
Family Medicine Physician
20764
WI
207Q00000X
Family Medicine Physician
22229
MN

Other

Enumeration date
01/30/2007
Last updated
04/02/2009
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