Provider Demographics
NPI:1922636984
Name:PECK, MEREDITH TRACY (DO)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:TRACY
Last Name:PECK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1879
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-1879
Mailing Address - Country:US
Mailing Address - Phone:603-254-2805
Mailing Address - Fax:
Practice Address - Street 1:237 MT. PROSPECT ROAD
Practice Address - Street 2:
Practice Address - City:HOLDERNESS
Practice Address - State:NH
Practice Address - Zip Code:03245
Practice Address - Country:US
Practice Address - Phone:603-254-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program