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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