Jake Allen Peterson
Oral and Maxillofacial Surgeon
3003 W Main St Ste 130
Boise
, Idaho 83702-2026
Jake Allen Peterson
Oral and Maxillofacial Surgeon
3003 W Main St Ste 130
Boise
, Idaho 83702-2026
(208) 342-7610
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Jake Allen Peterson
- 3003 W Main St Ste 130
- Boise, ID
- Zip : 83702-2026
- Phone : (208) 342-7610
Second Address
- Jake Allen Peterson
- 3003 W Main St Ste 130
- Boise, ID
- Zip : 83702-2026
- Phone : (208) 342-7610
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FAQs
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What type of doctor is Jake Allen Peterson
In what state does Jake Allen Peterson practice in?
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What is Jake Allen Peterson ’s gender?
Is Jake Allen Peterson a sole practitioner?
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Does Jake Allen Peterson accept insurance?
Does Jake Allen Peterson offers telemedicine?
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Does Jake Allen Peterson have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | D-5107-OS | ID |
| N | 1223S0112X | Oral and Maxillofacial Surgeon | DE60941667 | WA |
| N | 1223S0112X | Oral and Maxillofacial Surgeon | M-15171 | ID |
National Provider Identifier
| NPI | 1043657364 |
|---|---|
| Provider Name | Jake Allen Peterson |
| First Address | Boise, ID 83702-2026 |
| Second Address | Boise, ID 83702-2026 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/05/2013 |
| Last Update Date | 18/08/2020 |
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.