Doctor Name: | JOHN MICHAEL PEFFER |
NPI Number: | 1184920787 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 511 N Torch Blvd Bldg 300 Cannon Afb, NM - 881035109 |
Business Phone Number: | 5757840287 |
Business Fax Number: | |
Mailing Address: | 4505 Sandstone Dr, CLOVIS |
State: | NM |
Postal Code: | 881011037 |
Phone Number: | 2812221861 |
Fax Number: | |
NPI Enumeration Date: | 01/31/2011 |
NPI Last Update Date: | 02/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |