Individual
LANCE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
(307) 754-7747
Mailing address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
(307) 754-7747
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
8006A
WY
207P00000X
Emergency Medicine Physician
Primary
MD00035749
WA
207Q00000X
Family Medicine Physician
MD00035749
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8232787
—
WA
Enumeration date
11/16/2006
Last updated
06/24/2026
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