Dr. Mark Irwin Petersen, MD
Dr. Mark Irwin Petersen, MD is an Internal Medicine in Tonganoxie, Kansas. Graduated from University of Kansas School of Med (KC/WICH/SAL) in 1984, 42 years ago. Practices with Mid America Senior Management ACO LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Kansas.
- Years since qualifying
- 42
- Trained at
- University of Kansas School of Med (KC/WICH/SAL)
- Licensed in
- KS
- In the registry since
- 2006
- Specialties on file
- 2
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
21107 Donahoo RdTonganoxie, KS 66086-4153
Phone: (913) 742-4084
Fax: (913) 742-4086
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Internal Medicine Physician (primary) | Taxonomy 207R00000X · Licence 0421601 (KS) |
|---|---|
| Internal Medicine Physician | Taxonomy 207R00000X · Licence 04-21601 (KS) |
Record details
| NPI number | 1881647543 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | May 17, 2006 |
| Last updated in NPPES | October 8, 2024 |
| Certification date | October 8, 2024 |
| Mailing address | Po Box 996, Tonganoxie, KS 66086-0996 |
Medicare enrollment
| Medicare specialty | INTERNAL MEDICINE |
|---|---|
| Medical school | UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL) |
| Graduated | 1984 (42 years in practice) |
| Group practice | Mid America Senior Management Aco Llc — 3 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 4 on file with Medicare |
Other providers in Tonganoxie
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Mid America Senior Management ACO LLC
21107 Donahoo Rd, Tonganoxie, KS 66086-4153 · (913) 742-4084
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Mid America Senior Management LLC
21107 Donahoo Rd, Tonganoxie, KS 66086-4153 · (913) 742-4084