Mr. Wiley D Petersen, PA-C
Mr. Wiley D Petersen, PA-C is a Physician Assistant in Chubbuck, Idaho. Qualified in 2018, 8 years ago. Practices with Mvh Pic LLC, a 16-clinician group and accepts Medicare assignment. Licensed in Idaho.
- Years since qualifying
- 8
- Licensed in
- ID
- In the registry since
- 2019
What do these letters mean?
- PA-C — Physician Assistant, Certified
- A physician assistant who holds current national certification.
Practice location Address checks out
134 W Chubbuck RdChubbuck, ID 83202-2338
Phone: (208) 417-0102
Fax: (208) 242-3219
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence PA-1714 (ID) |
|---|
Record details
| NPI number | 1568920080 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA-C |
| Sole proprietor | Yes |
| NPI enumerated | March 4, 2019 |
| Last updated in NPPES | May 17, 2024 |
| Certification date | May 17, 2024 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2018 (8 years in practice) |
| Group practice | Mvh Pic Llc — 16 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
Other providers in Chubbuck
-
Mrs. Rachel M Koster, PA-C
4650 Hawthorne Rd Ste 3B, Chubbuck, ID 83202 · (208) 237-9833
-
Brent Leavitt
4928 Pleasant View Dr, Chubbuck, ID 83202-1640 · (208) 760-9416
-
Ryan T McCulloch, PA
147 W Chubbuck Rd, Chubbuck, ID 83202-2314 · (208) 238-7546
-
Mrs. Amy Louise McKinlay, PA-C
147 W Chubbuck Rd, Chubbuck, ID 83202-2314 · (208) 238-7546
-
Mitchel B Vellinga, CMA, PA-C
880 W Quinn Rd, Chubbuck, ID 83202-2454 · (208) 238-2000