1. Home
  2. Directory
  3. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

KENNY J PETERSON M.D.
NPI 1104815315
Obstetrics & Gynecology in Misawa Ab, AP

Active since October 19, 2005
35 MDOS/SGOPO, MISAWA AB, AP 96319(315) 226-6150(315) 226-6271 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 13, 2026, Jul 21, 2022 (2 updates tracked since 2022).

About Kenny J Peterson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNY J PETERSON M.D. (NPI 1104815315) is an individual obstetrics & gynecology provider in Misawa Ab, AP, licensed in Ohio (35-07-3341-P) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1104815315
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameKENNY J PETERSONCredential: M.D.
Location Address35 MDOS/SGOPOMisawa Ab, AP 96319
Mailing AddressPsc 76 Box 7634Apo, AP 96319 · (315) 226-6150 · Fax (315) 226-6271
Phone(315) 226-6150
Fax(315) 226-6271
Sole ProprietorNo
Enumeration DateOctober 19, 2005
Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration
✔ NPI 1104815315 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in OH · 35-07-3341-P
Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Other Identifiers 1

Other35-07-3341-POH · State License

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenny Peterson's NPI number?

The NPI number for Kenny Peterson is 1104815315. It was assigned to this individual provider in the NPPES registry on October 19, 2005.

Where is Kenny Peterson located?

Kenny Peterson practices at 35 Mdos/Sgopo, Misawa Ab, AP 96319. The listed phone number is (315) 226-6150.

What is Kenny Peterson's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

When was this NPI record last updated?

The NPPES record for Kenny Peterson was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.