Individual
DR. KATHRYN MARY PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260-2046
(317) 875-9105
(317) 808-8802
Mailing address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260-2046
(317) 875-9105
(317) 808-8802
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01072971A
IN
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
01072971
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062110012
MEDICARE PTAN
—
05
—
201186240
—
IN
Enumeration date
05/26/2008
Last updated
04/01/2024
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