Individual
ALLAN E PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
410 N 12TH ST, OSKALOOSA, IA 52577-2495
(641) 672-3360
(641) 672-2258
Mailing address
1229 C AVE E, OSKALOOSA, IA 52577-4246
(641) 672-3360
(641) 672-3366
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19419
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19419
LICENSE
IA
Enumeration date
10/11/2005
Last updated
07/18/2013
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