Individual
KIRK KEVIN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 S HWY 69, HUXLEY, IA 50124-8095
(515) 597-2600
(515) 597-3945
Mailing address
305 S US HIGHWAY 69, HUXLEY, IA 50124-8095
(515) 597-2600
(515) 597-3945
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30674
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255391983
—
IA
05
—
151100
—
IA
Enumeration date
03/25/2006
Last updated
08/09/2012
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