Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Clark E Petersen, MD

Individual provider Anesthesiology Physician · NPI 1275519894

Dr. Clark E Petersen, MD is an Anesthesiology in Layton, Utah. Graduated from Saint Louis University School of Medicine in 1989, 37 years ago. Accepts Medicare assignment. Licensed in Utah.

Years since qualifying
37
Trained at
Saint Louis University School of Medicine
Licensed in
UT
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1544 W Antelope Dr
Layton, UT 84041-1146
Phone: (801) 773-3339
Fax: (801) 773-6727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 3609501205 (UT)

Record details

NPI number1275519894
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 15, 2005
Last updated in NPPESJuly 13, 2026
Mailing address2551 Lewis Park Dr, Bountiful, UT 84010-5762

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolSAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 1989 (37 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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