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General NPI Number Information
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NPI Number | 1114960127
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Entity Type | Individual
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Provider Name | PEGGY MCDANNOLD M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 04/06/2017
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Provider Practice Location Address
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Address Line | 525 ALEXANDRIA PIKE SUITE 300
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City | SOUTHGATE
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State | KY
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Zip | 41071-3290
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Country | US
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Telephone | 859-781-2210
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Fax | 859-781-0289
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Provider Business Mailing Address
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Address Line | 525 ALEXANDRIA PIKE STE 300
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City | SOUTHGATE
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State | KY
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Zip | 41071-3290
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Country | US
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Telephone | 859-781-2210
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Fax | 859-781-0289
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 27527
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License Number State | KY
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