Individual
STEVE LEROY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1009 NORTH STATE OF FRANKLIN ACCESS ROAD, JOHNSON CITY, TN 37604
(423) 929-7546
(423) 929-7968
Mailing address
1009 NORTH STATE OF FRANKLIN ACCESS ROAD, JOHNSON CITY, TN 37604
(423) 929-7546
(423) 929-7968
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
39354
TN
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
39354
TN
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
39354
TN
Other
Enumeration date
05/23/2005
Last updated
11/05/2014
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