Randolph E Peterson (NPI# 1669461364, PAC ID# 6305826421) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1669461364 |
| PAC ID by PECOS | 6305826421 |
| Professional Enrollment ID | I20120124000946 |
| Full Name | Randolph E Peterson |
| Organization Legal Name | WEISER VALLEY HOSPITAL DISTRICT |
| Address |
645 E 5th St Weiser ID 83672-2202 |
| Phone Number | 2085490370 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE |
| Graduation Year | 1987 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 5294704276 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 131307 | WEISER MEMORIAL HOSPITAL |
| 130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 645 E 5th St, Weiser, ID 83672-2202 | 2085490370 | WEISER VALLEY HOSPITAL DISTRICT |
| Organization Legal Name | WEISER VALLEY HOSPITAL DISTRICT |
| Physicians | 19 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bradley Wescott Terry | Family Medicine | Weiser Valley Hospital District | 360 E Liberty St, Weiser, ID 83672-2261 |
| Brian L Mcmahan | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Andrea K Wheeler | Nurse Practitioner | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Einav Shochat | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| John C Kirkham | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Cody J Boyce | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| John S Waltz | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Blake D Niederhauser | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Michael A Fuchs | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Michael J Citrone | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Street Address |
645 E 5TH ST |
| City | WEISER |
| State | ID |
| Zip | 83672-2202 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brian L Mcmahan | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Andrea K Wheeler | Nurse Practitioner | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Einav Shochat | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| John C Kirkham | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Cody J Boyce | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| John S Waltz | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Blake D Niederhauser | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Michael A Fuchs | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Michael J Citrone | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Shane K Ball | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher J Jennings | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Elaine N Daniel | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Benjamin Joseph Morrissey | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Quinn A Demordaunt | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Wayne M Mortensen | Diagnostic Radiology | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Bryan L Drake | Family Practice | Weiser Valley Hospital District | 645 E 5th St, Weiser, ID 83672-2202 |
| Julie M Mills | Emergency Medicine | Weiser Valley Hospital District | 645 E 5th St, Memorial Hosp Specialty Clinic, Weiser, ID 83672-2202 |
| Suzanna Hubele | Family Medicine | Two Rivers Medical Clinic, Pa | 683 E 3rd St, Weiser, ID 83672-2248 |
| Selena J Ankarberg | Nurse Practitioner | Two Rivers Medical Clinic, Pa | 683 E 3rd St, Weiser, ID 83672-2248 |
| Lore B Wootton | Family Medicine | Two Rivers Medical Clinic, Pa | 683 E 3rd St, Weiser, ID 83672-2248 |
| Find all physicians in zip 83672 | |||
| City | WEISER |
| Zip Code | 83672 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | WEISER + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Randolph E Peterson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.