| Anthony Michael Petersen, MD | |
|
6550 S Millrock Dr Ste 250, Salt Lake City, UT 84121-2331 | |
| (801) 821-2781 | |
| (801) 901-1194 |
| Full Name | Anthony Michael Petersen |
|---|---|
| Gender | Male |
| Speciality | Psychiatry |
| Experience | 14 Years |
| Location | 6550 S Millrock Dr Ste 250, Salt Lake City, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336407790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 8797789-1205 (Utah) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD457218 (Pennsylvania) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lakeview Hospital | Bountiful, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mountainstar Behavioral Health Llc | 1052558186 | 13 |
| Entity Name | Mountainstar Behavioral Health Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174868525 PECOS PAC ID: 1052558186 Enrollment ID: O20130605000270 |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony Michael Petersen, MD 6550 S Millrock Dr Ste 250, Salt Lake City, UT 84121-2331 Ph: (801) 821-2613 | Anthony Michael Petersen, MD 6550 S Millrock Dr Ste 250, Salt Lake City, UT 84121-2331 Ph: (801) 821-2781 |
Dr. Eric Thayne Monson, MD, PHD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 501 S Chipeta Way, Salt Lake City, UT 84108 Phone: 801-581-4096 | |
Dr. Gerald Martin Lazar, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 2005 E 2700 S, Suite 180, Salt Lake City, UT 84109 Phone: 801-746-2297 Fax: 801-322-3890 | |
Leah M. Fortson, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: Huntsman Mental Health Institute, 501 Chipeta Way, Salt Lake City, UT 84108 Phone: 801-581-4096 | |
Christopher R. Sweeney, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1336 S 1100 E, Salt Lake City, UT 84105 Phone: 385-246-2522 Fax: 801-810-1343 | |
Norman L. Foster, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 50 N Medical Dr, Salt Lake City, UT 84132 Phone: 801-585-6387 | |
Dr. Amy Gallop Weagley, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 501 S Chipeta Way, Salt Lake City, UT 84108 Phone: 801-581-2121 | |
Lawrence H Climo, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: Comphealth 4021 South 700 East, Suite 300, Salt Lake City, UT 84107 Phone: 800-453-3030 |