Petersen, Scott Richard

Petersen, Scott Richard is an individual health care provider with primary practice located at 500 W Thomas Rd Suite 400, Phoenix AZ 85013-4224. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Trauma Surgery is his primary health care specialty. Petersen, Scott Richard can be contacted via phone (602) 406-3157.

Contact Information

Primary practice address
500 W Thomas Rd Suite 400 Phoenix AZ 85013-4224
Phone: (602) 406-3157
Fax: (602) 406-4113
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 14414 Arizona
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X 14414 Arizona
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 14414 Arizona

Profile Details

NPI number 1912986555
LBN Legal business name Petersen, Scott Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2006
Last updated Jul 19th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912986555 NPPES
Arizona MEDICAID 231720

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