Organization
CENTER FOR ADVANCED PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS L PETERSON MD FACS (PARTNER)
(435) 628-2895
Entity
Organization
Contact information
Practice address
676 S BLUFF ST, SUITE 207, ST GEORGE, UT 84770-3596
(435) 628-2895
(435) 628-5943
Mailing address
676 S BLUFF ST, SUITE 207, ST GEORGE, UT 84770-3596
(435) 628-2895
(435) 628-5943
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
345016
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004328723
AETNA
KY
01
—
0007137728
AETNA
UT
01
—
101009187101
IHC RHODES
UT
01
—
107007770102
IHC PET
UT
01
—
19344612000001
VALUECARE
UT
01
—
2085401
BCBS NV
NV
01
—
902568
DMBA
UT
Enumeration date
05/12/2006
Last updated
08/22/2020
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