Individual
DR. JOSEPH T. PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
911 BYPASS RD, PIKEVILLE, KY 41501-1689
(606) 218-3500
Mailing address
PO BOX 2917, PIKEVILLE, KY 41502-2917
(606) 218-3500
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
34198
KY
2085R0001X
Radiation Oncology Physician
MD-067177-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001765945
HIGHMARK BLUE CROSS
PA
05
—
1013753370001
—
PA
Enumeration date
08/12/2006
Last updated
06/11/2013
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