Mark Petersen, MD

NPI 1881647543 · on the registry since 2006

Practice

Address: 21107 Donahoo Rd
Tonganoxie, KS 66086
Phone: (913) 742-4084
Fax: (913) 742-4086
Organisation at this address: Mid America Senior Management Llc
Mid America Senior Management Aco Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 6

Registry record

Primary taxonomy: 207R00000X
207R00000X
Also registered as: 207R00000X
Licence states on file: KS
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2024-10-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kansas