Provider Demographics
NPI:1750565586
Name:D. MICHAEL MCPEAK D.C., INC.
Entity type:Organization
Organization Name:D. MICHAEL MCPEAK D.C., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCPEAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-622-3553
Mailing Address - Street 1:1101 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-1323
Mailing Address - Country:US
Mailing Address - Phone:740-622-3553
Mailing Address - Fax:740-622-5270
Practice Address - Street 1:1101 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812
Practice Address - Country:US
Practice Address - Phone:740-622-3553
Practice Address - Fax:740-622-5270
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D. MICHAEL MCPEAK D.C., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-28
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2443111N00000X
OH1277111N00000X
OH923111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0479736Medicaid
OH0921266Medicaid
OH2009150Medicaid
OH0142965Medicaid
OH0479736Medicaid
OH0778763Medicare PIN
OH0507293Medicare PIN
OHU40845Medicare UPIN
OH0921266Medicaid
OH2009150Medicaid
OH9278481Medicare PIN
OH0507291Medicare PIN
OH0829421Medicare PIN