Individual
PAUL CARL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 20TH ST, SUITE 503, KNOXVILLE, TN 37916-1809
(865) 541-4321
(865) 541-4320
Mailing address
501 20TH ST, SUITE 503, KNOXVILLE, TN 37916
(865) 541-4321
(865) 541-4320
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD0000027743
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3099553
—
TN
Enumeration date
09/15/2005
Last updated
06/24/2020
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