MR. RICHARD KENNETH PETERSON M.D.
NPI 1508858861
Family Medicine in Jacksonville, FL

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

Active since August 22, 2005

2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204(904) 308-7372(904) 308-2998 Get Directions Write a Review

NPPES record last updated: November 11, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mr. Richard Kenneth Peterson M.d. NPPES

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

MR. RICHARD KENNETH PETERSON M.D. (NPI 1508858861) is an individual family medicine provider in Jacksonville, Florida, licensed in Florida (ME0067446) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1508858861

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameMR. RICHARD KENNETH PETERSONCredential: M.D.

Location Address2627 RIVERSIDE AVEJacksonville, FL 32204-4712

Mailing Address2627 Riverside AveJacksonville, FL 32204-4712 · (904) 308-7372 · Fax (904) 308-2998

Phone(904) 308-7372

Fax(904) 308-2998

Sole ProprietorNo

Enumeration DateAugust 22, 2005

Last NPPES UpdateNovember 11, 2009

✔ NPI 1508858861 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · ME0067446

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.

2627 RIVERSIDE AVE, Jacksonville, FL 32204

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Other Identifiers 8

Medicare ID-Type Unspecified26755YFL

Other080119192FL · Medicare Railroad

Other5562171-001FL · Cigna

Other4653879FL · Aetna

Medicare UPING03267FL

Other148899FL · Healthease

Other26755FL · Bcbs

Medicaid379680900FL

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.

MR. BELTON CRAIG RAY M.D.

Family Medicine (Geriatric Medicine)