Search › Utah › 2082S0099X
Jason Petersen, MD
NPI 1215105804 · on the registry since 2008
Practice
- Address
- 5353 S 960 E
#150
Salt Lake City, UT 84117 - Phone
- (801) 261-5791
- Fax
- (801) 747-7740
- Organisation at this address
- J. Dayne Petersen M.D., Pc
Mindnautilus.Com Corporation Dba EnablemartInferred from a shared address, not stated in the registry. - Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 2082S0099X
2082S0099X
- Also registered as
- 208200000X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-08-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah