Organization
ERIC C MCPEAK OD PA
Active
Parent organization
ERIC C MCPEAK OD PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
ERIC C MCPEAK OD PA
Authorized official
DR. ERIC C MCPEAK O.D. (OWNER, PRESIDENT)
(785) 742-3021
Entity
Organization
Contact information
Practice address
706 OREGON ST, HIAWATHA, KS 66434-2232
(785) 742-3021
(785) 742-3061
Mailing address
PO BOX 336, HIAWATHA, KS 66434-0336
(785) 742-3021
(785) 742-3061
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100357060C
—
KS
01
—
410049838
RR MC
KS
01
—
650920
GROUP NUMBER
KS
Enumeration date
09/26/2006
Last updated
07/05/2011
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