Individual
DR. PETER A INNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
603-2 N PROGRESS AVE STE 200, SILOAM SPRINGS, AR 72761-4206
(479) 215-3040
(479) 524-4363
Mailing address
PO BOX 859, PAYSON, AZ 85547-0859
(928) 472-3472
(928) 472-3480
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01-28693
KS
208600000X
Surgery Physician
04-28693
KS
208600000X
Surgery Physician
Primary
43678
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100421520B
—
KS
05
—
100421520D
—
KS
05
—
549477
—
AZ
Enumeration date
08/13/2006
Last updated
09/15/2021
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