NPI 1104815315

Kenny J Peterson, MD

Practitioner Obstetrics & Gynecology Physician Misawa Ab, AP

Practice location

Address: 35 Mdos/Sgopo, Misawa Ab, AP 96319
Phone: (315) 226-6150
Fax: (315) 226-6271
Mailing address: Psc 76 Box 7634, Apo, AP 96319

Registered specialties

Obstetrics & Gynecology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207V00000X Licence 35-07-3341-P (OH)

Other Obstetrics & Gynecology providers in Armed Forces Pacific →

Registry record

NPI: 1104815315
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Oct 2005
Record last updated: 13 Jul 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.