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RANDOLPH E PETERSON NPI 1679752802


NPI Information

NPI: 1679752802
Provider Name: RANDOLPH E PETERSON
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
840 SW 4TH AVENUE
ONTARIO, OR
ZIP 97914
Phone: (541) 889-2899
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RANDOLPH E PETERSON is an orthopaedic surgery in Ontario, OR. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. RANDOLPH E PETERSON NPI is 1679752802. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

840 SW 4TH AVENUE
ONTARIO, OR
ZIP 97914-627
Phone: (541) 889-2899

The provider's authorized official is Leslie Peterson .
The authorized official title is Manager and has the following contact phone number (541) 889-2899.

The enumeration date for this NPI number is 10/24/2007 and was last updated on 10/24/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207X00000XOrthopaedic Surgery19969OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1135827MEDICAIDOREGON
2119509MEDICARE PIN
3G31149MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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