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

Dr. Mack Andelin Peterson, DO

Individual provider Family Medicine Physician · NPI 1396159521

Dr. Mack Andelin Peterson, DO is a Family Medicine Physician in Jbsa Lackland, Texas. Licensed in Nebraska. Registered with an NPI since 2014.

Licensed in
NE
In the registry since
2014
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland, TX 78236-5638
Phone: (315) 630-4060
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 1535 (NE)

Record details

NPI number1396159521
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 16, 2014
Last updated in NPPESJuly 8, 2024
Certification dateJuly 8, 2024
Mailing address1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638

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