| Russell D Peterson, DO | |
|
965 Us Hwy 431, Roanoke, AL 36274 | |
| (334) 863-2141 | |
| (334) 863-8733 |
| Full Name | Russell D Peterson |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 45 Years |
| Location | 965 Us Hwy 431, Roanoke, Alabama |
| 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 |
|---|---|---|---|
| 1144322504 | NPI | - | NPPES |
| 51091244 | Other | AL | BCBS OF ALABAMA |
| 000091244 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DO436 (Alabama) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Compassus-gadsden | Southside, AL | Hospice |
| Tanner Medical Center-east Alabama | Wedowee, AL | Hospital |
| Roanoke Rehabilitation & Healthcare Center | Roanoke, AL | Nursing home |
| Traylor Retirement Community | Roanoke, AL | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tanner Primary Care Of Roanoke Inc | 1153663091 | 5 |
| Howard T Tee Md Pllc | 9234490426 | 2 |
| Entity Name | Howard T Tee Md Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194231712 PECOS PAC ID: 9234490426 Enrollment ID: O20180305000922 |
| Mailing Address | Practice Location Address |
|---|---|
| Russell D Peterson, DO Po Box 625, Roanoke, AL 36274-0625 Ph: (334) 863-2141 | Russell D Peterson, DO 965 Us Hwy 431, Roanoke, AL 36274 Ph: (334) 863-2141 |
Michael Robinson, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1950 Main St., Roanoke, AL 36274 Phone: 334-863-2311 Fax: 334-863-5596 | |
Dr. Mitchell Carey Shirah, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 59664 Highway 22, Roanoke, AL 36274 Phone: 334-863-8952 Fax: 334-863-2361 |