Provider Demographics
NPI:1801994264
Name:PEAK, JAMES H (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:PEAK
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 1:1645 AVENUE D STE C
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3043
Mailing Address - Country:US
Mailing Address - Phone:406-702-4662
Mailing Address - Fax:
Practice Address - Street 1:1645 AVENUE D STE C
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3043
Practice Address - Country:US
Practice Address - Phone:406-702-4662
Practice Address - Fax:406-702-1740
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT75352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT8HZ61QOtherMEDICARE CROW
MT8HZL44OtherMEDICARE PRYOR
MT0102388OtherMDCD PIN
WY109476900OtherMDCD PIN
MT8HZ71QOtherMEDICARE LG
MT000018441OtherBCBS PIN
MT260041318Medicare PIN
MT0102388OtherMDCD PIN
MTF74662Medicare UPIN