Individual
DR. HORACE REX PETERSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4040 LA QUESTA DR, NEOSHO, MO 64850-2849
(417) 451-1833
(417) 451-1825
Mailing address
4040 LA QUESTA DR, NEOSHO, MO 64850-2849
(417) 451-1833
(417) 451-1825
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
R9N57
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13190
BLUE CROSS
MO
Enumeration date
07/13/2005
Last updated
07/08/2007
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