Provider Demographics
NPI:1093014672
Name:PEEK, MEAGAN LEE
Entity Type:Individual
Prefix:DR
First Name:MEAGAN
Middle Name:LEE
Last Name:PEEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1711
Mailing Address - Country:US
Mailing Address - Phone:502-584-3200
Mailing Address - Fax:502-584-3333
Practice Address - Street 1:731 E BROADWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1711
Practice Address - Country:US
Practice Address - Phone:502-584-3200
Practice Address - Fax:502-584-3333
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1309652080P0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology