Individual
PAUL D PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2600 OUTER DR N, SIOUX CITY, IA 51104-1585
(712) 239-3300
(712) 239-8201
Mailing address
200 GOLD CIR STE 120, DAKOTA DUNES, SD 57049-5501
(605) 217-0700
(605) 217-0701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03181
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4186098
—
IA
05
—
75305796314
—
NE
05
—
7786682
—
SD
Enumeration date
02/22/2006
Last updated
02/27/2026
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