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Individual
DR. TIMOTHY PECK
Active
Individual
DR. TIMOTHY PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038007895
IL
111N00000X
Chiropractor
Primary
1488
AL
111N00000X
Chiropractor
6062
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06007868
BCBS ILLINOIS
IL
01
—
105091
BCBS MISSOURI
MO
01
—
1891268439
BC ALABAMA
AL
01
—
30447
GHP
—
01
—
371384821
TRICARE
—
01
—
4400120
UHC
—
01
—
U39962
MERCY
—
Enumeration date
03/21/2006
Last updated
11/02/2023
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