Individual provider · NPI-1

Kyle David Peterson, MD

Emergency Medicine · Port Arthur, TX

NPI number1922335199
StatusActive
Last updated in NPPESNov 10, 2009

Details

NPI
1922335199
Entity type
Individual (NPI-1)
Name
Kyle David Peterson
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Nov 10, 2009
Last updated
Nov 10, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207P00000X Emergency MedicineN4663TXYes

Practice location

3600 Gates Blvd
Port Arthur, TX 77642-3858

Phone 800-893-9698

Mailing address

200 Corporate Blvd
Suite 201
Lafayette, LA 70508-3870

Phone 800-893-9698

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