Individual
DR. SCOTT CY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
540 W 5TH ST STE 340, ODESSA, TX 79761-5036
(432) 640-3445
Mailing address
PO BOX 847408, DALLAS, TX 75284-7408
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K9149
TX
Other
Enumeration date
07/19/2006
Last updated
06/12/2024
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