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

Dr. Mark William Peterson, DO

Individual provider Family Medicine Physician · NPI 1326374562

Dr. Mark William Peterson, DO is a Family Practice in Park City, Utah. Graduated from Arizona College of Osteopathic Medicine Mid Western University in 2009, 17 years ago. Practices with Avera McKennan, a 962-clinician group and accepts Medicare assignment. Licensed in Arkansas, Michigan and Utah.

Years since qualifying
17
Trained at
Arizona College of Osteopathic Medicine Mid Western University
Licensed in
AR, MI, UT
In the registry since
2009
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2200 Park Ave Bldg D Ste 100
Park City, UT 84060
Phone: (435) 615-8822
Fax: (435) 615-8823
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence 8743560-1204 (UT)
Family Medicine Physician Taxonomy 207Q00000X · Licence 5101018542 (MI)
Family Medicine Physician Taxonomy 207Q00000X · Licence E7679 (AR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 5101018542 (MI)

Record details

NPI number1326374562
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedOctober 22, 2009
Last updated in NPPESFebruary 18, 2020
Certification dateFebruary 18, 2020
Mailing address101 Sun Meadow Dr, Centerton, AR 72719-9610

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Graduated 2009 (17 years in practice)
Group practice Avera McKennan — 962 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Park City