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NPI Code Detail

MEDICARE: DR. CRAIG MATTHEW PEKNY M.D.

MEDICARE: DR. CRAIG MATTHEW PEKNY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician6218NE

General Provider Information

NPI Number : 1386964260
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRAIG MATTHEW PEKNY M.D.
Provider Business Mailing Address
First Line : 1454 28TH AVE
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-4944
Country : US
Telephone Number : 402-564-2816
Fax Number : 402-564-1312
Provider Business Practice Location Address
First Line : 1454 28TH AVE
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-4944
Country : US
Telephone Number : 402-564-2816
Fax Number : 402-564-1312
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2010
Last Update Date : 01/11/2021

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