Provider Demographics
NPI:1417943655
Name:PEGG, WILLIAM MCKEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MCKEAN
Last Name:PEGG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 277219
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7219
Mailing Address - Country:US
Mailing Address - Phone:800-919-1190
Mailing Address - Fax:706-737-2272
Practice Address - Street 1:6500 66TH ST
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-5030
Practice Address - Country:US
Practice Address - Phone:727-347-1286
Practice Address - Fax:727-828-1460
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 44943207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B42089Medicare UPIN
FL23321XMedicare PIN