Individual
DR. RANDALL ERIK PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4039 GATEWAY BLVD, GROVETOWN, GA 30813-3195
(706) 922-1600
(706) 922-1010
Mailing address
PO BOX 2510, EVANS, GA 30809-2510
(706) 650-7799
(706) 650-9540
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
14-036
GA
207Q00000X
Family Medicine Physician
Primary
72759
GA
Other
Enumeration date
05/10/2010
Last updated
03/21/2024
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