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NPI Code Detail

MEDICARE: REGINALD THOMAS PEAKE M.D.

MEDICARE: REGINALD THOMAS PEAKE 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
12085R0202XDiagnostic Radiology PhysicianE2780TX

General Provider Information

NPI Number : 1548372337
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINALD THOMAS PEAKE M.D.
Provider Business Mailing Address
First Line : 4801 E LINWOOD BLVD
Second Line : ROOM 2444
City : KANSAS CITY
State : MO
Zip : 64128-2226
Country : US
Telephone Number : 816-861-4700
Fax Number : 816-922-4643
Provider Business Practice Location Address
First Line : 4801 E LINWOOD BLVD
Second Line : ROOM 2444
City : KANSAS CITY
State : MO
Zip : 64128-2226
Country : US
Telephone Number : 816-861-4700
Fax Number : 816-922-4643
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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