Dr. Jerry D Peterie
Infectious Disease
310 S Hillside St
Wichita
, Kansas 67211-2129
Dr. Jerry D Peterie
Infectious Disease
310 S Hillside St
Wichita
, Kansas 67211-2129
(316) 264-0908
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About
Features
Specialties
- Infectious Disease
Languages spoken
- English
Location
First Address
- Dr. Jerry D Peterie
- 310 S Hillside St
- Wichita, KS
- Zip : 67211-2129
- Fax : (316) 264-0908
- Phone : (316) 264-3505
Second Address
- Dr. Jerry D Peterie
- 310 S Hillside St
- Wichita, KS
- Zip : 67211-2129
- Fax : (316) 264-0908
- Phone : (316) 264-3505
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RI0200X | Infectious Disease | 0416578 | KS |
National Provider Identifier
| NPI | 1023014305 |
|---|---|
| Provider Name | Dr. Jerry D Peterie |
| First Address | Wichita, KS 67211-2129 |
| Second Address | Wichita, KS 67211-2129 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/06/2005 |
| Last Update Date | 03/08/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| B69246 | (02) | KS |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.