PHILLIP H PETERSEN MD
NPI 1295730661
Family Medicine in Orofino, ID

Q: What is Phillip Petersen's NPI number?

The NPI number for Phillip Petersen is 1295730661. It was assigned to this individual provider in the NPPES registry on June 14, 2005.

Q: What is Phillip Petersen's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Phillip Petersen was last updated on December 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 14, 2005

301 CEDAR ST, OROFINO, ID 83544(208) 476-4555(208) 476-5385 Get Directions Write a Review

NPPES record last updated: December 19, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Phillip H Petersen Md NPPES

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

PHILLIP H PETERSEN MD (NPI 1295730661) is an individual family medicine provider in Orofino, Idaho, licensed in Idaho (M5405) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1295730661

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NamePHILLIP H PETERSENCredential: MD

Location Address301 CEDAR STOrofino, ID 83544-9029

Mailing Address301 Cedar StOrofino, ID 83544-9029 · (208) 476-4555 · Fax (208) 476-5385

Phone(208) 476-4555

Fax(208) 476-5385

Sole ProprietorNo

Enumeration DateJune 14, 2005

Last NPPES UpdateDecember 19, 2017

✔ NPI 1295730661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in ID · M5405

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

301 CEDAR ST, Orofino, ID 83544

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Other Identifiers 1

Medicaid003883100ID

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLEARWATER VALLEY HOSPITAL & CLINICS

Clinic/Center (Rural Health)