Organization
DARRYL W. PETERSON, MD, APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARRYL W PETERSON (MD)
(225) 454-6000
Entity
Organization
Contact information
Practice address
7855 HOWELL BLVD, STE 200, BATON ROUGE, LA 70807-5257
(225) 454-6000
(225) 302-7255
Mailing address
7855 HOWELL BLVD, STE 200, BATON ROUGE, LA 70807-5257
(225) 454-6000
(225) 302-7255
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD12182R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1543365
—
LA
Enumeration date
09/03/2008
Last updated
09/03/2008
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