Provider Demographics
NPI:1215937339
Name:PEEK, JANE BARCLAY (MD)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:BARCLAY
Last Name:PEEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8595 PICARDY AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3670
Mailing Address - Country:US
Mailing Address - Phone:225-237-1880
Mailing Address - Fax:225-237-1899
Practice Address - Street 1:8595 PICARDY AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3670
Practice Address - Country:US
Practice Address - Phone:225-237-1880
Practice Address - Fax:225-237-1899
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA014780207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1543322Medicaid
57305Medicare ID - Type Unspecified
LA1543322Medicaid