Provider Demographics
NPI:1982246047
Name:GESSNER PETERSON HOUSE CALLS INC
Entity type:Organization
Organization Name:GESSNER PETERSON HOUSE CALLS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GESSNER-PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-778-5011
Mailing Address - Street 1:41 E 400 N # 316
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-4020
Mailing Address - Country:US
Mailing Address - Phone:801-577-8678
Mailing Address - Fax:801-206-7736
Practice Address - Street 1:41 E 400 N # 316
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-4020
Practice Address - Country:US
Practice Address - Phone:801-577-8678
Practice Address - Fax:801-206-7736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty