Organization
JANA PETERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA M PETERS DO (OWNER)
(304) 425-3922
Entity
Organization
Contact information
Practice address
365 COURTHOUSE ROAD, PRINCETON, WV 24740
(304) 425-3922
(304) 487-0229
Mailing address
365 COURTHOUSE ROAD, PRINCETON, WV 24740
(304) 425-3922
(304) 487-0229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
WV381
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720758
MT STATE BCBS
WV
05
—
0041701001
—
WV
Enumeration date
03/06/2007
Last updated
01/04/2012
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