Organization
PETERSEN NEUROSPINE, PLLC
Active
Organization
PETERSEN NEUROSPINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENDT P PETERSEN III MD (PHYSICIAN)
(251) 607-6117
Entity
Organization
Contact information
Practice address
6701 AIRPORT BLVD, BUILDING D SUITE 100, MOBILE, AL 36608-6765
(251) 607-6117
(251) 219-0746
Mailing address
6701 AIRPORT BLVD, BUILDING D SUITE 100, MOBILE, AL 36608-6765
(251) 607-6117
(251) 219-0746
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
248545
—
AL
Enumeration date
09/30/2019
Last updated
08/04/2022
Update your record
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