Healthcare Provider Details

I. General information

NPI: 1730345729
Provider Name (Legal Business Name): JOSEPH D. PEGGS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5829 E AGAVE PLACE
CAREFREE AZ
85377
US

IV. Provider business mailing address

PO BOX 5829 5829 E AGAVE PL
CAREFREE AZ
85377
US

V. Phone/Fax

Practice location:
  • Phone: 480-772-2374
  • Fax:
Mailing address:
  • Phone: 480-772-2374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number40814
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: