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

John J Petersen, PA

Individual provider Surgical Physician Assistant · NPI 1164580429

John J Petersen, PA is a Surgical Physician Assistant in Medford, Oregon. Licensed in Oregon. Registered with an NPI since 2006.

Licensed in
OR
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

520 Medical Center Dr Ste 201
Medford, OR 97504-4334
Phone: (541) 789-5710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA00228 (OR)

Record details

NPI number1164580429
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 5, 2006
Last updated in NPPESJanuary 16, 2013
Mailing address2620 E Barnett Rd, Suite H, Medford, OR 97504-8344

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