| Jedidiah Allen Petersen, PA | |
|
6 13th Ave E, Polson, MT 59860-5315 | |
| (406) 883-5680 | |
| (406) 883-8960 |
| Full Name | Jedidiah Allen Petersen |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 11 Years |
| Location | 6 13th Ave E, Polson, Montana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366870206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA-1110 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Partners In Home Care Inc | Missoula, MT | Home health agency |
| Providence St Joseph Medical Center | Polson, MT | Hospital |
| St. Patrick Hospital | Missoula, MT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Providence St Joseph Medical Center | 0446230247 | 41 |
| Mailing Address | Practice Location Address |
|---|---|
| Jedidiah Allen Petersen, PA Po Box 262, Liberty Lake, WA 99019-0262 Ph: (208) 232-7862 | Jedidiah Allen Petersen, PA 6 13th Ave E, Polson, MT 59860-5315 Ph: (406) 883-5680 |
Joshua Russell, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 106 Ridgewater Dr Ste A, Polson, MT 59860 Phone: 406-883-3200 Fax: 406-883-9483 | |
Angela Lemire, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 6 13th Ave E, Polson, MT 59860 Phone: 406-883-5680 | |
Timothy W. Thornton, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 6 13th Ave E, Polson, MT 59860 Phone: 406-883-5680 Fax: 406-883-8910 | |
Taylor M Lies, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 106 Ridgewater Dr Ste A, Polson, MT 59860 Phone: 406-883-3200 Fax: 406-883-9483 | |
Tanner Ryan Staley, Physician Assistant Medicare: Medicare Enrolled Practice Location: 104 Rufus Ln, Polson, MT 59860 Phone: 406-883-2555 Fax: 406-883-2559 | |
Amy M. Johnson, FNP Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: #5 4th Ave. E., Polson, MT 59860 Phone: 406-745-3525 Fax: 406-745-3529 |