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

Dallas Peterson MD PLLC

Organization Family Medicine Physician · NPI 1043526569

Dallas Peterson MD PLLC provides Family Medicine Physician services in Lakeside, Arizona. Licensed in Arizona. Registered with an NPI since 2010.

Licensed in
AZ
In the registry since
2010
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3401 Lockwood Dr
Lakeside, AZ 85929-5613 Not confirmed with CMS for 16 years — call before visiting
Phone: (928) 368-2060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence AZ23268 (AZ)

Record details

NPI number1043526569
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gina Crowe — Administrator · (928) 537-7011
NPI enumeratedAugust 21, 2010
Last updated in NPPESAugust 21, 2010
Mailing address1600 S White Mountain Rd, Show Low, AZ 85901-7106

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