Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JASON DAYNE PETERSEN, MD
ActiveDR. JASON DAYNE PETERSEN, MD is a Plastic Surgery within the Head & Neck healthcare provider located in SALT LAKE CITY, Utah. NPI 1215105804 is currently active in the NPPES registry. Verify at CMS.
Plastic Surgery within the Head & Neck · SALT LAKE CITY, UT
Registration Details
- NPI Number
- 1215105804
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 15, 2008 (18.509111228255 yrs)
- Last Updated
- Aug 7, 2012
- Licenses
-
83185641205 (UT)83185641205 (UT)
Practice Information
- Address
-
5353 S 960 E#150SALT LAKE CITY, UT, 841173569Browse UT providers · Browse ZIP 84117
- Phone
- 8012615791
- Fax
- 8017477740
- Primary Specialty
-
Plastic Surgery within the Head & Neck
2082S0099X
- Additional Specialty
- Plastic Surgery within the Head & Neck
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.