Provider Demographics
NPI:1801891106
Name:MCPEAK, GAIL H (OD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:H
Last Name:MCPEAK
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Gender:M
Credentials:OD
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Mailing Address - Street 1:414 LINCOLN ST
Mailing Address - Street 2:P.O. BOX 269
Mailing Address - City:WAMEGO
Mailing Address - State:KS
Mailing Address - Zip Code:66547-1682
Mailing Address - Country:US
Mailing Address - Phone:785-456-2247
Mailing Address - Fax:785-456-9230
Practice Address - Street 1:414 LINCOLN ST
Practice Address - Street 2:P.O. 269
Practice Address - City:WAMEGO
Practice Address - State:KS
Practice Address - Zip Code:66547-1682
Practice Address - Country:US
Practice Address - Phone:785-456-2247
Practice Address - Fax:785-456-9230
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2013-08-15
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Provider Licenses
StateLicense IDTaxonomies
KS1037-2152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0312360001OtherPTAN