Individual
DR. CACEY WILLIAM PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1380 E MEDICAL CENTER DR, SAINT GEORGE, UT 84790-2123
(435) 251-1000
Mailing address
1430 TULANE AVE # SL-79, NEW ORLEANS, LA 70112-2632
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
67275
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
12888572-1235
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12888572-1205
—
UT
01
—
67275
AZ MEDICAL LICENSE
—
Enumeration date
03/31/2015
Last updated
01/17/2024
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