Individual
ALEX ELDON PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-6175
(541) 274-6739
Mailing address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-6556
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO205183
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2018
Last updated
08/31/2021
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