Peck, Irving
Peck, Irving is an sole proprietor health care provider with primary practice located at 1937 Old Main St Suite 2, Maysville KY 41056. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Peck, Irving can be contacted via phone (606) 759-7311.Contact Information
Primary practice address
1937 Old Main St Suite 2
Maysville KY 41056
Phone: (606) 759-7311
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | 0396 | Kentucky |
Profile Details
| NPI number | 1063563104 |
|---|---|
| LBN Legal business name | Peck, Irving |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 16th, 2007 |
| Last updated | Dec 10th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063563104 | NPPES |
| Kentucky | MEDICAID | 52800976 | |
| Kentucky | MEDICAID | 0559408 | |
| Kentucky | MEDICAID | 52903960 | |
| Kentucky | Other | 000000077313 |
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