Provider Demographics
NPI:1871557181
Name:PECK, THOMAS STUART (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:STUART
Last Name:PECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24435-0405
Mailing Address - Country:US
Mailing Address - Phone:540-377-2156
Mailing Address - Fax:540-377-9476
Practice Address - Street 1:33 RED HILL RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:VA
Practice Address - Zip Code:24435-2137
Practice Address - Country:US
Practice Address - Phone:540-377-2156
Practice Address - Fax:540-377-9476
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101040211207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine