Individual
DR. ERIC YANCEY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 W COUNTRY CLUB RD, ROSWELL, NM 88201-5892
(575) 622-6322
(575) 622-6888
Mailing address
PO BOX 2608, ROSWELL, NM 88202-2608
(575) 622-6322
(575) 622-6888
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
95-322
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E9898
—
NM
Enumeration date
05/17/2006
Last updated
06/28/2010
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