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Individual

DR. PETER T PHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6122
(816) 271-6019
Mailing address
12814 NE 115TH TER, KEARNEY, MO 64060-9121
(816) 419-0146

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2006022551
MO
207P00000X
Emergency Medicine Physician
Primary
E-4675
AR

Other

Enumeration date
05/16/2006
Last updated
10/09/2024
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