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Individual

DR. TIMOTHY PECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
2934 POINT MALLARD PKWY SE STE B2, DECATUR, AL 35603-5710
(256) 584-9554
(256) 253-5502
Mailing address
14608 WATERVIEW LN, ATHENS, AL 35613-1606
(618) 977-5419
(256) 253-5502

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038007895
IL
111N00000X
Chiropractor
Primary
1488
AL
111N00000X
Chiropractor
6062
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06007868
BCBS ILLINOIS
IL
01
105091
BCBS MISSOURI
MO
01
1891268439
BC ALABAMA
AL
01
30447
GHP
01
371384821
TRICARE
01
4400120
UHC
01
U39962
MERCY
Enumeration date
03/21/2006
Last updated
11/02/2023
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