Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Stacy L Peterson, MD

Individual provider Plastic and Reconstructive Surgery Physician · NPI 1316030638

Dr. Stacy L Peterson, MD is a Plastic and Reconstructive Surgery Physician in Wichita, Kansas. Practices as a sole proprietor. Licensed in Kansas.

Licensed in
KS
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

818 N Emporia St Ste 305
Wichita, KS 67214-3729
Phone: (316) 265-1441
Fax: (316) 265-1685
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X · Licence 0419242 (KS)

Record details

NPI number1316030638
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 30, 2006
Last updated in NPPESJuly 8, 2007

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