Provider Demographics
NPI:1194599134
Name:PEAKMEDIQ OCCUPATIONAL MEDICINE, LLC
Entity type:Organization
Organization Name:PEAKMEDIQ OCCUPATIONAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KORNSE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MBA, MSHA
Authorized Official - Phone:720-908-8751
Mailing Address - Street 1:4809 ARGONNE ST STE 150
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-6837
Mailing Address - Country:US
Mailing Address - Phone:720-608-8255
Mailing Address - Fax:
Practice Address - Street 1:4809 ARGONNE ST STE 150
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-6837
Practice Address - Country:US
Practice Address - Phone:720-608-8255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine