DR. MARK WILLIAM PETERSON


Address: 2200 Park Ave. Bldg. D Ste. 100, Park City, UT 84060
Phone: 4356158822

DR. MARK WILLIAM PETERSON (NPI# 1326374562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326374562
Entity Type Individual
Full Name DR. MARK WILLIAM PETERSON
Credential DO
Practice Address 2200 Park Ave. Bldg. D Ste. 100
Park City
UT 84060
Mailing Address 101 Sun Meadow Dr
Centerton
AR 72719-9610
Practice Telephone 4356158822
Practice Fax Number 4356158823
Mailing Telephone 4797950426
Enumeration Date 2009-10-22
Last Update Date 2020-02-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine E7679 AR Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine 5101018542 MI Allopathic & Osteopathic Physicians
Y 207QS0010X Family Medicine
Specialization: Sports Medicine
8743560-1204 UT Allopathic & Osteopathic Physicians
N 390200000X Student in an Organized Health Care Education/Training Program 5101018542 MI Student, Health Care

Other Providers MARK PETERSON

NPI Name Taxonomy Address Enumeration
1164069696 Mark Alan Peterson In Home Supportive Care 5870 Nw 54th Ct, Johnston, IA 50131-1418 2019-12-03
1841474012 Mark Frederic Peterson I Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 3351 36th St, Grand Rapids, MI 49331 2007-12-24
1780877258 Mark A. Peterson Counselor 7322 Scenic Oaks Cir, Austin, TX 78745-5217 2007-08-19
1871702076 Mark Clayton Peterson Dentist 1600 W Sunset Rd Ste B, Henderson, NV 89014-2655 2007-05-22
1558481366 Mark Theodore Peterson Specialist 5712 Newburg Rd, Rockford, IL 61108-6707 2007-03-29
1073608170 Mark A Peterson Dentist 7740 Bay St, Suite # 1, Sebastian, FL 32958-3427 2006-10-04
1689782864 Mark L Peterson Dentist 127 1/2 E Short St, Rigby, ID 83442-1422 2006-08-28
1528013661 Mark Edward Peterson Dentist 2440 Gaynor Nw, Grand Rapids, MI 49544-1830 2006-05-24
1699763607 Mark Delano Peterson Orthopaedic Surgery 1311 E Barnett Rd, Ste 201, Medford, OR 97504-8225 2005-10-12
1477551836 Mark Dean Peterson Chiropractor 5406 Alderson St, Schofield, WI 54476-2264 2005-07-11

Office Location

Street Address 2200 PARK AVE. BLDG. D STE. 100
City PARK CITY
State UT
Zip Code 84060

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851406011 Lindsey Elizabeth Marshall Physician Assistant 2200 Park Ave. Bldg. D Ste. 100, Park City, UT 84060 2006-08-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982233920 Livecare, Inc. Nursing Care 1830 Prospector Avenue, Park City, UT 84060 2020-04-02
1063904266 Louise Knetzger Gallagher Acupuncturist 1107 Woodside Ave, Park City, UT 84060 2018-06-04
1942753421 Valerie Alison Mey Dietitian, Registered 2985 Arabian Dr, Park City, UT 84060 2016-08-01
1659720936 Vibrant Health PC Anesthesiology 1910 Prospector Ave Suite 302, Park City, UT 84060 2016-06-08
1538538657 Pamela Hilbert Dentist 1830 Prospector Ave., Park City, UT 84060 2015-09-18
1174904924 Julie Anna Bullen Counselor 2300 Monitor Drive, Park City, UT 84060 2015-06-17
1265825319 William Gary Smith Obstetrics & Gynecology 2501 Creek Drive, Park City, UT 84060 2015-03-13
1497026330 Earl Warren Stadler Jr. Physical Medicine & Rehabilitation 1500 Three Kings Drive Unit 31, Park City, UT 84060 2012-01-24
1538454541 Belinda Duncan Pharmacist 2700 E Deer Valley Dr B105, Park City, UT 84060 2011-06-17
1184888315 Cody Michael Calderwood Dentist 1600 Snow Creek Dr Ste A, Park City, UT 84060 2008-07-16
Find all providers in zip 84060

Taxonomy Information

Taxonomy Code 207QS0010X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Sports Medicine

Taxonomy Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1720169915 Stuart Eliot Willick Family Medicine 1493 Lowell Ave, Park City, UT 84060 2006-10-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1053702431 Weber State University Family Medicine 1001 University Cir, Ogden, UT 84408-5525 2015-02-06
1043210248 Trek Lyons Family Medicine 1300 N 500 E, Suite 130, Logan, UT 84341-2408 2005-07-28
1316323165 Dixie State University Family Medicine 225 S 700 E, St George, UT 84770-3875 2015-08-04
1285013987 Sportsmed Associates LLC Family Medicine 3401 N Center St, Ste 100, Lehi, UT 84043-7497 2015-05-27
1164826665 University of Utah Adult Services Family Medicine 555 Foothill Dr, Salt Lake City, UT 84112-1106 2014-10-14
1164860573 Brett Wayne Martindale Family Medicine 4700 Harrison Blvd, Ogden, UT 84403-4303 2013-06-07
1053631069 Tye Harrison Family Medicine 1350 N 500 E, Logan, UT 84341-2400 2010-06-02
1720303837 Nicholas E Monson Family Medicine 2132 N 1700 W, 230, Layton, UT 84041-7057 2010-03-31
1346478476 Ryan Albert Slater Family Medicine 1184 E 80 N, American Fork, UT 84003-2906 2009-06-26
1922232867 Christopher R. Gordon Family Medicine 1157 N 300 W, Provo, UT 84604-6124 2009-05-06
Find all providers with the same taxonomy

Competitor

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City PARK CITY
Zip Code 84060

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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