Individual
DR. JOHNATHAN W PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMS, PA-C
Contact information
Practice address
607 S BROADWAY, COWETA, OK 74429-5000
(918) 486-5564
Mailing address
607 S BROADWAY, COWETA, OK 74429-5000
(918) 486-5564
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4971
OK
363A00000X
Physician Assistant
Primary
PA9117435
FL
363A00000X
Physician Assistant
—
OK
Other
Enumeration date
01/10/2023
Last updated
02/12/2026
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