Individual
DR. BRYAN LUCAS PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2520 5TH ST N, COLUMBUS, MS 39705-2008
(662) 244-1584
(662) 244-2086
Mailing address
350 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2177
(901) 226-4003
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2020-04511
NC
2085R0202X
Diagnostic Radiology Physician
Primary
36552
MS
2085R0202X
Diagnostic Radiology Physician
OS14808
FL
2085R0202X
Diagnostic Radiology Physician
UO3382
FL
208D00000X
General Practice Physician
UO3382
FL
Other
Enumeration date
01/14/2013
Last updated
05/08/2026
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