IndividualActive
Stacy Peterson, M.D.
NPI 1316030638 · Plastic and Reconstructive Surgery Physician · Wichita, KS
Provider details
- NPI number
- 1316030638
- Entity type
- Individual
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 0419242 (KS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
818 N Emporia St
Suite 305
Wichita, KS 67214-3729
Phone: (316) 265-1441
Fax: (316) 265-1685
Approximate (ZIP-level) locationGet directions
Mailing address
818 N Emporia St
Wichita, KS 67214-3729
Registry dates
- Enumerated
- 2006-09-30
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.