Individual
WARREN HOWARD PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
123 W SALEM AVE, INDIANOLA, IA 50125-2518
(515) 961-2809
(515) 961-0768
Mailing address
123 W SALEM AVE, INDIANOLA, IA 50125-2518
(515) 961-2809
(515) 961-0768
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01825
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1219980
—
IA
01
—
22-0315
UNITED HEALTH CARE
IA
01
—
26901
BLUE CROSS BLUE SHIELD
IA
01
—
67284
COVENTRY HEALTH CARE
IA
Enumeration date
09/20/2006
Last updated
07/08/2007
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