Joseph R Peterson MD PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

JOSEPH R PETERSON MD PA

Practice address

1414 E Blanco Rd
Suite 9
Boerne, TX 78006-1834

Phone

(830) 249-6321

Fax

(830) 249-7138

NPI assigned

Aug 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joseph Roger Peterson, M.D.

Title

President

Phone

(830) 249-6321

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1376737726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E BLANCO RD",
            "address_2": "SUITE 9",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780061834",
            "telephone_number": "830-249-6321",
            "fax_number": "830-249-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 E BLANCO RD",
            "address_2": "SUITE 9",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780061834",
            "telephone_number": "830-249-6321",
            "fax_number": "830-249-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH R PETERSON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "830-249-6321",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Boerne, TX
• Providers in Boerne, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.