Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Daniel W Peterson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1992190003

Daniel W Peterson is a Pathology in Jackson, Tennessee. Graduated from University of South Alabama College of Medicine in 2015, 11 years ago. Practices with Jackson Pathology Group a Professional Corporation, a 6-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
11
Trained at
University of South Alabama College of Medicine
Licensed in
TN
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

620 Skyline Dr
Jackson, TN 38301-3923
Phone: (731) 541-6026
Fax: (731) 541-7958
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 17 Davis Blvd Ste 308, Tampa, FL 33606-3438 — (813) 396-2515

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 60752 (TN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1992190003
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 6, 2015
Last updated in NPPESApril 16, 2021
Certification dateApril 16, 2021
Mailing address8900 Spring Grv N, Mobile, AL 36695-5327

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolUNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Jackson Pathology Group A Professional Corporation — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Jackson