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PEGGY JO REEP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
725 VIXEN RUN, GATLINBURG, TN 37738-6344
(865) 430-3453
(866) 898-2159
Mailing address
23625 COMMERCE PARK, SUITE 204, BEACHWOOD, OH 44122-5845
(216) 255-5700
(866) 898-2159

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
17306
OK
2085R0202X
Diagnostic Radiology Physician
Primary
41949
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1477079
LA
05
200052500A
OK
01
502461641001
BCBS-LAWTON
OK
01
5623606
AETNA
OK
05
8557050
WA
01
P00225875
RAILROAD MEDICARE
OK
Enumeration date
09/21/2005
Last updated
02/05/2010
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