Peterson, Walter
Peterson, Walter is an individual health care provider with primary practice located at 250 Red Cliffs Dr , St George UT 84790-8167. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Peterson, Walter can be contacted via phone (435) 674-2020.Contact Information
Primary practice address
250 Red Cliffs Dr
St George UT 84790-8167
Phone: (435) 674-2020
Fax: (435) 674-3470
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1093699934 | Utah |
Profile Details
| NPI number | 1851480081 |
|---|---|
| LBN Legal business name | Peterson, Walter |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2006 |
| Last updated | Jul 26th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851480081 | NPPES |
| Utah | MEDICAID | 999000797009 | |
| Utah | Other | 87017934025001 |
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