Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEDIDIAH ALLEN PETERSEN, PA
ActivePhysician Assistant · POLSON, MT
Registration Details
- NPI Number
- 1366870206
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 30, 2013 (12.481019072927 yrs)
- Last Updated
- Dec 8, 2015
- License
-
PA-1110 (ID)
Practice Information
- Address
-
6 13TH AVE EPOLSON, MT, 598605315Browse MT providers · Browse ZIP 59860
- Phone
- 4068835680
- Fax
- 4068838960
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in POLSON, MT
| Name | Credential | NPI |
|---|---|---|
| CODY BROWN | PA-C | 1598837239 |
| TIMOTHY W. THORNTON | PA-C | 1083778278 |
| WADE PAUL SHIPLEY | PA-C | 1962531913 |
| ERIC M SCHALLOCK | PA | 1477874600 |
| LOUIS CONRAD BRENNER | PA-C | 1609205905 |
| STEPHEN ANDREW SHEPRO | PA-C | 1437541471 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.