Individual
HUGH PETERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 S JACKSON ST, LOUISVILLE, KY 40202-1622
(502) 562-6510
(502) 562-6515
Mailing address
501 E BROADWAY, #220, LOUISVILLE, KY 40202-1785
(502) 589-4856
(502) 589-5093
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19236
KY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
19236
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64192362
—
KY
Enumeration date
01/04/2006
Last updated
02/13/2017
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