National Provider Identifier Database

JASON D PETERSEN, MD – NPI #1215105804
Plastic Surgery Within the Head and Neck

A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them.


Contact Information

JASON D PETERSEN, MD
5353 S 960 E
#150
SALT LAKE CITY, UT84117-3569
Phone: 801-261-5791
Fax: 801-747-7740
Website:
Specialty Taxonomy Code
* Plastic Surgery Within the Head and Neck 2082S0099X
Plastic Surgery 208200000X

* Indicates primary specialty

NPI Profile & details for JASON D PETERSEN

NPI Number 1215105804
Credentials MD
Entity Individual
Enumeration date 02/15/2008
Last updated 08/07/2012 - About 14 years ago
Sole proprietor1 No
Identifiers
  • UT License #: 83185641205
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for JASON D PETERSEN, MD

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