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General NPI Number Information
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NPI Number | 1346213832
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Entity Type | Organization
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Legal Business Name | RICHARD W. PEFFLEY, DPM, A
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 03/14/2011
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Provider Practice Location Address
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Address Line | 350 MILLER ST SE
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City | SALEM
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State | OR
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Zip | 97302-4248
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Country | US
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Telephone | 503-370-8784
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Fax | 503-362-4017
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Provider Business Mailing Address
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Address Line | 350 MILLER ST SE
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City | SALEM
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State | OR
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Zip | 97302-4248
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Country | US
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Telephone | 503-370-8784
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Fax | 503-362-4017
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD W PEFFLEY II
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Credential | DPM
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Telephone | 503-370-8784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DP00219
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License Number State | OR
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