Healthcare Provider Details

I. General information

NPI: 1801117031
Provider Name (Legal Business Name): APEX OBSTETRICS AND GYNECOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 06/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 HEALTHPLEX WAY SUITE 201
APEX NC
27502-8403
US

IV. Provider business mailing address

120 HEALTHPLEX WAY SUITE 201
APEX NC
27502-8403
US

V. Phone/Fax

Practice location:
  • Phone: 919-651-9866
  • Fax:
Mailing address:
  • Phone: 919-651-9866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number139505
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. LANFORD PECK
Title or Position: PHYSICIAN/CEO
Credential: M.D.
Phone: 919-651-9866