Individual
JON T PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2871 GREENSBORO RD, MARTINSVILLE, VA 24112-8108
(276) 638-2273
Mailing address
2871 GREENSBORO RD, MARTINSVILLE, VA 24112-8108
(276) 638-2273
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101052027
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010064325
—
VA
05
—
1407870975
—
VA
05
—
8906672
—
NC
Enumeration date
07/27/2006
Last updated
08/22/2022
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