Peklo, Timothy Michael

Peklo, Timothy Michael is an individual health care provider with primary practice located at 601 W 2Nd St , Bloomington IN 47403-2317. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Peklo, Timothy Michael can be contacted via phone (812) 353-9515.

Contact Information

Primary practice address
601 W 2Nd St Bloomington IN 47403-2317
Phone: (812) 353-9515
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01048993 Indiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01048993A Indiana

Profile Details

NPI number 1811985229
LBN Legal business name Peklo, Timothy Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Aug 21st, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811985229 NPPES
Indiana MEDICAID 200224010

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