Provider Demographics
NPI:1831212596
Name:MCPEEK, JENNIFER JEAN (DO)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JEAN
Last Name:MCPEEK
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 773323
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477-3323
Mailing Address - Country:US
Mailing Address - Phone:970-879-9362
Mailing Address - Fax:866-511-0120
Practice Address - Street 1:942 OAK STREET
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487
Practice Address - Country:US
Practice Address - Phone:970-879-9362
Practice Address - Fax:866-511-0120
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38739204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07433727Medicaid
COC800985Medicare PIN