NPI 1750542452

Kylan D Peterson, DO

Practitioner Otolaryngology/Facial Plastic Surgery Physician Twin Falls, ID

Practice location

Address: 730 N College Rd Suite B, Twin Falls, ID 83301-3382
Phone: (208) 814-7350
Fax: (208) 732-8508
Mailing address: PO Box 587, Twin Falls, ID 83303-0587

Registered specialties

Otolaryngology/Facial Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207YX0905X Licence O0713 (ID)

Other Otolaryngology providers in Idaho →

Registry record

NPI: 1750542452
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Jun 2008
Record last updated: 2 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.