Individual
JOHN DAVID PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
301 FISHER ST, BILOXI, MS 39534-2508
(228) 376-0425
Mailing address
301 FISHER ST, BILOXI, MS 39534-2508
(228) 376-0425
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
83119
SC
208600000X
Surgery Physician
Primary
LL83119
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2020
Last updated
07/29/2026
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