Provider Demographics
NPI:1356680755
Name:PELTON, JAMES KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KENNETH
Last Name:PELTON
Suffix:
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 1:12025 HORSESHOE LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-6238
Mailing Address - Country:US
Mailing Address - Phone:714-470-9650
Mailing Address - Fax:
Practice Address - Street 1:11900 E CORNELL AVE
Practice Address - Street 2:UNIT C
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-6201
Practice Address - Country:US
Practice Address - Phone:714-470-9650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80409207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine