Individual
DR. BAILEY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2019021906
MO
152W00000X
Optometrist
OPC005841
FL
207W00000X
Ophthalmology Physician
Primary
OPC5841
FL
Other
Enumeration date
07/21/2020
Last updated
09/09/2020
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