Individual
JASON RUSSELL PECK
Active
Individual
JASON RUSSELL PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
33116
SC
208000000X
Pediatrics Physician
L8471
TX
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
33116
SC
2080P0203X
Pediatric Critical Care Medicine Physician
45451
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31162
—
SC
Enumeration date
12/12/2006
Last updated
03/23/2018
Update your record
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