Individual
JACOB PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1115 E 20TH ST, SIOUX FALLS, SD 57105-1013
(605) 575-1644
Mailing address
3603 S BANYAN AVE, SIOUX FALLS, SD 57110-4505
(605) 553-0517
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/02/2025
Last updated
05/02/2025
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