Provider Demographics
NPI:1235221433
Name:PEGHEE, DONALD G JR (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:G
Last Name:PEGHEE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11879 W 112TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-4101
Mailing Address - Country:US
Mailing Address - Phone:913-334-2880
Mailing Address - Fax:913-334-2898
Practice Address - Street 1:11879 W 112TH ST STE 300
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-4101
Practice Address - Country:US
Practice Address - Phone:913-334-2880
Practice Address - Fax:913-334-2898
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022003321207V00000X
KS0432139207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200422820FMedicaid
KS200422820FMedicaid