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General NPI Number Information
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NPI Number | 1164315560
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Entity Type | Organization
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Legal Business Name | PEAK HEALTH MEDICAL GROUP LLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 127 E MAIN ST STE A
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City | PAYSON
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State | AZ
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Zip | 85541-5646
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Country | US
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Telephone | 928-492-9222
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Fax |
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Provider Business Mailing Address
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Address Line | 13921 W GRAND AVE BLDG E
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City | SURPRISE
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State | AZ
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Zip | 85374-2439
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Country | US
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Telephone | 904-994-4532
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/CFO
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Name | CHIKA UGORJI
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Credential | MD
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Telephone | 928-951-0395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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