Provider Demographics
NPI:1114289626
Name:PEYTON CARE PROFESSIONALS, LLC
Entity Type:Organization
Organization Name:PEYTON CARE PROFESSIONALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:PEYTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:419-893-9230
Mailing Address - Street 1:111 CLINTON STREET
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537
Mailing Address - Country:US
Mailing Address - Phone:419-893-9230
Mailing Address - Fax:419-893-6912
Practice Address - Street 1:118 E INDIANA AVE
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-2826
Practice Address - Country:US
Practice Address - Phone:419-893-9230
Practice Address - Fax:419-893-6912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty