MEDICARE: RED LEDGES DERMATOLOGY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	179077-1204	UT

General Provider Information

NPI Number	:	1417467986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RED LEDGES DERMATOLOGY PLLC

Provider Business Mailing Address
First Line	:	1449 N 1400 W STE 22
Second Line	:
City	:	ST GEORGE
State	:	UT
Zip	:	84770-5237
Country	:	US
Telephone Number	:	435-703-9296
Fax Number	:

Provider Business Practice Location Address
First Line	:	1449 N 1400 W STE 22
Second Line	:
City	:	ST GEORGE
State	:	UT
Zip	:	84770-5237
Country	:	US
Telephone Number	:	435-703-9296
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WARREN ALBERT PETERERSON
Credential	:	DO
Telephone Number	:	435-703-9296

Provider Enumeration Date	:	10/10/2017
Last Update Date	:	03/08/2018

Similar Medicare Providers

1043325715 — MR. STEPHEN JASON TOMLINSON PT
Practice Location Address:

1449 N 1400 W STE 21
ST GEORGE, UT
84770-5237

Practice Phone: 435-986-4133
Practice Fax: 435-986-4133

1801063441 — PAIUTE INDIAN TRIBE OF UTAH
Practice Location Address:

1449 N 1400 W STE 19
ST GEORGE, UT
84770-5237

Practice Phone: 354-688-8199
Practice Fax: 435-688-7572

1083069793 — MR. DAMION D. RODEBACK PA-C
Practice Location Address:

1449 N 1400 W STE 22
ST GEORGE, UT
84770-5237

Practice Phone: 435-703-9296
Practice Fax: 435-215-4075

1477156214 — MR. SPENCER W SCHMUTZ PA-C
Practice Location Address:

1449 N 1400 W STE 19
ST GEORGE, UT
84770-5237

Practice Phone: 435-688-7572
Practice Fax: 435-275-4939

1295477172 — MR. TYLER CHAD CARTER PA
Practice Location Address:

1449 N 1400 W STE 19
SAINT GEORGE, UT
84770-5237

Practice Phone: 435-688-7572
Practice Fax:

1629716170 — TAYLOR WENDELL HUNSAKER OD
Practice Location Address:

1449 N 1400 W STE 24
ST GEORGE, UT
84770-5237

Practice Phone: 435-656-2003
Practice Fax:

Directions to “RED LEDGES DERMATOLOGY PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.