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Organization

DARRYL W. PETERSON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DARRYL WAYNE PETERSON M.D. (PHYSICIAN)
(225) 454-6000
Entity
Organization

Contact information

Practice address
7855 HOWELL PLACE BLVD, SUITE 200, BATON ROUGE, LA 70807-5256
(225) 454-6000
(225) 454-2603
Mailing address
7855 HOWELL BLVD, BATON ROUGE, LA 70807
(225) 454-6000
(225) 454-6016

Taxonomy

Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
012182R
LA

Other

Enumeration date
06/15/2011
Last updated
06/15/2011
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