Individual
DR. JOHN E. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
104 N 7 HIGHWAY, SUITE B, BLUE SPRINGS, MO 64014
(816) 229-8880
(816) 229-4363
Mailing address
104 N 7 HIGHWAY, SUITE B, BLUE SPRINGS, MO 64014
(816) 229-8880
(816) 229-4363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO36953
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15256101
BC/BS
MO
01
—
2024981
AETNA
MO
Enumeration date
08/24/2005
Last updated
12/05/2011
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