Healthcare Provider Details

I. General information

NPI: 1093014672
Provider Name (Legal Business Name): MEAGAN LEE PEEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 S ENGLISH STATION RD
LOUISVILLE KY
40245-3996
US

IV. Provider business mailing address

161 S ENGLISH STATION RD
LOUISVILLE KY
40245-3996
US

V. Phone/Fax

Practice location:
  • Phone: 502-861-6067
  • Fax: 502-515-8728
Mailing address:
  • Phone: 502-861-6067
  • Fax: 502-515-8728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080B0002X
TaxonomyPediatric Obesity Medicine Physician
License Number53259
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number53259
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number53259
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: