Individual
DR. JON ERIC PETTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3175 POCAHONTAS RD, BAKER CITY, OR 97814-1434
(541) 523-4415
(541) 523-2399
Mailing address
3175 POCAHONTAS RD, BAKER CITY, OR 97814-1434
(541) 523-4415
(541) 523-2399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD11174
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219170
—
OR
05
—
227616
—
OR
01
—
MD11174
STATE MED LIC
OR
Enumeration date
07/10/2006
Last updated
07/09/2007
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