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Individual

DR. PHILLIP O PEGG JR.

Active
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Individual

DR. PHILLIP O PEGG JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1390
KY
103TC0700X
Clinical Psychologist
Primary
PYT0122
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01644526
RAILROAD MEDICARE
MO
Enumeration date
06/22/2006
Last updated
06/10/2016
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