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Organization
CENTER FOR PLASTIC SURGERY, PA
Active
Organization
CENTER FOR PLASTIC SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK TELLIN PETERSON JR. MD (CEO)
(785) 234-9000
Entity
Organization
Contact information
Practice address
631 SW HORNE ST, SUITE 400, TOPEKA, KS 66606-1694
(785) 234-9000
(785) 234-9119
Mailing address
631 SW HORNE ST, SUITE 400, TOPEKA, KS 66606-1694
(785) 234-9000
(785) 234-9119
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
11/24/2009
Last updated
11/24/2009
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