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

Kenny J Peterson, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1104815315

Kenny J Peterson, MD is an Obstetrics & Gynecology Physician in Armed Forces Pacific. Licensed in Ohio. Registered with an NPI since 2005.

Licensed in
OH
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Incomplete address

The federal record is missing the street or ZIP for this provider.

35 Mdos/sgopo
Misawa Ab, AP 96319
Phone: (315) 226-6150
Fax: (315) 226-6271

No coordinates on file. Search this address in Google Maps

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 35-07-3341-P (OH)

Record details

NPI number1104815315
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 19, 2005
Last updated in NPPESJuly 13, 2026