DR. Thea E Petersen, MD

NPI #1083887087 in Cottage Grove, Oregon

Provider Information

NPI Number: 1083887087
Entity Type: Individual
Name: DR. Thea E Petersen, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: MD
Enumeration Date: Apr 10, 2008
Last Updated: Apr 10, 2023

Practice Location

Address: 1515 VILLAGE DR STE 220
City: Cottage Grove
State: Oregon
ZIP Code: 97424-9700
Phone: (541) 767-5200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Family Medicine	207Q00000X	Primary

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