Individual
IRVING PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1937 OLD MAIN ST, SUITE 2, MAYSVILLE, KY 41056
(606) 759-7311
Mailing address
1937 OLD MAIN ST, SUITE 2, MAYSVILLE, KY 41056
(606) 759-7311
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
0396
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000077313
BCBS
KY
05
—
0559408
—
OH
05
—
52800976
—
KY
05
—
52903960
—
KY
Enumeration date
01/16/2007
Last updated
12/10/2008
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