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
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8232787
—
WA
Enumeration date
11/16/2006
Last updated
12/22/2025
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