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

Dr. Scott Richard Petersen, MD

Individual provider Surgery Physician · NPI 1912986555

Dr. Scott Richard Petersen, MD is a Surgery Physician in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2006.

Licensed in
AZ
In the registry since
2006
Specialties on file
3
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

500 W Thomas Rd Ste 400
Phoenix, AZ 85013-4224
Phone: (602) 406-3157
Fax: (602) 406-4113
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Trauma Surgery Physician (primary) Taxonomy 2086S0127X · Licence 14414 (AZ)
Surgery Physician Taxonomy 208600000X · Licence 14414 (AZ)
Surgical Critical Care Physician Taxonomy 2086S0102X · Licence 14414 (AZ)

Record details

NPI number1912986555
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 12, 2006
Last updated in NPPESJuly 19, 2012

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