Provider Demographics
NPI:1700066768
Name:MAUGHAN, PETER HANKS (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:HANKS
Last Name:MAUGHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5171 COTTONWOOD ST
Mailing Address - Street 2:SUITE 950
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5704
Mailing Address - Country:US
Mailing Address - Phone:801-507-9555
Mailing Address - Fax:801-507-9550
Practice Address - Street 1:5171 COTTONWOOD ST
Practice Address - Street 2:SUITE 950
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5704
Practice Address - Country:US
Practice Address - Phone:801-507-9555
Practice Address - Fax:801-507-9550
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT72721081205207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery