Derek Petersen, PA-C

NPI #1104365113 in Ogden, Utah

Provider Information

NPI Number: 1104365113
Entity Type: Individual
Name: Derek Petersen, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Feb 23, 2017
Last Updated: Feb 3, 2026

Practice Location

Address: 2240 ADAMS AVE
City: Ogden
State: Utah
ZIP Code: 84401-1511
Phone: (801) 393-5355

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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