Healthcare Provider Details

I. General information

NPI: 1023747649
Provider Name (Legal Business Name): PEAKS URGENT CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 06/08/2022
Certification Date: 06/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

956 W. ANEMONE TRAIL
DILLON CO
80435-8043
US

IV. Provider business mailing address

PO BOX 6132
CHESTERFIELD MO
63006-6132
US

V. Phone/Fax

Practice location:
  • Phone: 314-308-7681
  • Fax: 314-666-8848
Mailing address:
  • Phone: 314-640-1632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NIZAR ASSI
Title or Position: OWNER, CEO
Credential: MD
Phone: 314-640-1632