Individual
JAY T. PETERSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6429 HIGH DR, MISSION HILLS, KS 66208-1935
(913) 722-5825
Mailing address
6429 HIGH DR, MISSION HILLS, KS 66208-1935
(913) 722-5825
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
04-14230
KS
207RH0003X
Hematology & Oncology Physician
Primary
R6888
MO
Other
Enumeration date
02/01/2006
Last updated
01/05/2009
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