Provider Demographics
NPI:1386964260
Name:PEKNY, CRAIG MATTHEW (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:MATTHEW
Last Name:PEKNY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-4944
Mailing Address - Country:US
Mailing Address - Phone:402-564-2816
Mailing Address - Fax:402-564-1312
Practice Address - Street 1:1454 28TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-4944
Practice Address - Country:US
Practice Address - Phone:402-564-2816
Practice Address - Fax:402-564-1312
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine