DR. SPENCER O'BRIEN PETERSON (NPI# 1962851667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962851667 |
Entity Type | Individual |
Full Name | DR. SPENCER O'BRIEN PETERSON |
Credential | D.O. |
Practice Address |
4175 S. Alamo Ave Tucson AZ 85707-4405 |
Practice Telephone | 5202282700 |
Mailing Telephone | 5202282700 |
Enumeration Date | 2016-06-03 |
Last Update Date | 2020-08-10 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgery | R-07-2016MNT | NM | Allopathic & Osteopathic Physicians |
Y | 208000000X | Pediatrics | 11236456-1204 | UT | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376186858 | Spencer Girard Peterson | Specialist/Technologist | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2019-10-28 |
1740426048 | Spencer Howard Peterson Jr. | Internal Medicine | 835 E 18th Ave Ste 110, Denver, CO 80218 | 2008-12-17 |
Street Address |
4175 S. ALAMO AVE |
City | TUCSON |
State | AZ |
Zip Code | 85707-4405 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841699196 | Kristie Martin | Social Worker | 4175 S. Alamo Ave, Tucson, AZ 85707-4405 | 2014-08-21 |
1992369276 | Mellissa Taylor | Physician Assistant | 4175 S. Alamo Ave, Tucson, AZ 85707-4405 | 2019-04-23 |
1336502772 | Agin Gheevarughese Thomas | Psychiatry & Neurology | 4175 S. Alamo Ave, Tucson, AZ 85707-4405 | 2016-04-02 |
1336505700 | Sidonia Williamson | Clinic/Center | 4175 S. Alamo Ave, Tucson, AZ 85707-4405 | 2016-01-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699128850 | Megan Dehaven | Specialist/Technologist | 5455 E Comanche St, Tucson, AZ 85707 | 2016-07-22 |
1780927954 | Ryan N Taylor | Physician Assistant | 400, 4175 S Alamo Ave, Davis-monthan Afb, AZ 85707 | 2013-04-05 |
1154658839 | Alisha A Marchetti | Physician Assistant | 4175 S. Alamo Avenue, 355th Mdg/mdos, Davis-monthan Afb, AZ 85707 | 2009-11-17 |
1851529192 | Christopher Thomas Yarbrough | Military Health Care Provider | 4625 South Phoenix Street Bldg 4843, Tucson, AZ 85707 | 2009-06-25 |
1144457045 | Denise Fabian | Psychiatry & Neurology | 5427 E. Madera Street, Davis Monthan Afb, AZ 85707 | 2009-06-17 |
1942437447 | Emerson M Earle | Military Health Care Provider | 4625 S. Phoenix St, Bld 4843, Tucson, AZ 85707 | 2009-06-11 |
1164657136 | Raul Romero | Military Health Care Provider | 4575 S. Phoenix St. 563rd Oss, Dmafb, AZ 85707 | 2009-05-20 |
1063647196 | Virginia E. Bailey | Military Health Care Provider | 4837 S Phoenix St., Rm 119 Davis-monthan Air Force Base, Tucson, AZ 85707 | 2009-05-19 |
1043417611 | Jacob Riis | Orthopaedic Surgery | 355 Mdg, 4175 South Alamo Ave, Tucson, AZ 85707 | 2007-06-28 |
1508989732 | Christopher E. Dunham | Physician Assistant | 4175 S. Alamo Ave Bldg 400, 355th Medical Group-davis Monthan Afb, Tucson, AZ 85707 | 2007-04-10 |
Find all providers in zip 85707 |
Taxonomy Code | 208000000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235793100 | Jacquelyn Christine Wagner | Pediatrics | 1625 N Campbell, Tucson, AZ 85719 | 2019-04-26 |
1952965212 | Jeremey William Gneck | Pediatrics | 1625 N Campbell Ave Tucson Az 85719, Tucson, AZ 85724-0001 | 2019-04-23 |
1992295158 | Melanie Anne Kaplanek | Pediatrics | 1501 N Campbell Ave Rm 3301, Tucson, AZ 85724-0001 | 2018-05-14 |
1003352154 | Pleasant Pediatrics Plc | Pediatrics | 1601 N Oracle Rd, Tucson, AZ 85705-6440 | 2017-01-13 |
1134570211 | Eryn Simmons | Pediatrics | 1620 W Commerce Ct, Tucson, AZ 85746-6005 | 2016-06-29 |
1063860518 | Rachael Charles | Pediatrics | 2621 N Woodland Rd, Tucson, AZ 85749-9576 | 2016-05-25 |
1376998294 | Drew Carter Johnson | Pediatrics | 1625 N Campbell Ave Rm 3301, Tucson, AZ 85719-4330 | 2016-04-28 |
1609280742 | Emily Nicole Lawson | Pediatrics | 826 W Placita Estrella Azul, Tucson, AZ 85713-1595 | 2014-06-17 |
1598184020 | John Paul Jarczyk | Pediatrics | University of Arizona Dept of Pediatrics, 1501 N. Campbell Ave., Tucson, AZ 85724-0001 | 2014-04-11 |
1558780346 | Leo Warren Landau Md | Pediatrics | 11702 E Saint James Rd, Tucson, AZ 85748-7928 | 2014-04-09 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.