Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. WILEY D PETERSEN, PA-C
Active Sole ProprietorMR. WILEY D PETERSEN, PA-C is a Physician Assistant healthcare provider located in CHUBBUCK, Idaho. NPI 1568920080 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · CHUBBUCK, ID
Registration Details
- NPI Number
- 1568920080
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 4, 2019 (7.4122235368656 yrs)
- Last Updated
- May 17, 2024
- License
-
PA-1714 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
134 W CHUBBUCK RDCHUBBUCK, ID, 832022338Browse ID providers · Browse ZIP 83202
- Phone
- 2084170102
- Fax
- 2082423219
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in CHUBBUCK, ID
| Name | Credential | NPI |
|---|---|---|
| LESLIE IRENE BURNSIDE | PA-C | 1760451454 |
| MRS. AMY LOUISE MCKINLAY | PA-C | 1992716674 |
| RYAN T MCCULLOCH | PA | 1720195530 |
| RENEE LYNN KATTER | PA-C | 1053502955 |
| MRS. RACHEL M KOSTER | PA-C | 1437469830 |
| BRENT LEAVITT | — | 1740650548 |
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.