John J. Petersen, PA
Surgical PA · Medford, OR
UnclaimedPANPI 1164580429
- Primary taxonomy
- 363AS0400X
- Enumerated
- 2006-12-05
- Practice location
- Medford, OR
- Last NPPES update
- 2013-01-16
State licenses
- OR · Physician assistant · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.