Provider Demographics
NPI:1699070052
Name:PEECHER, CARRIE M (DO)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:M
Last Name:PEECHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2305 SOUTH 65 HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340-3702
Mailing Address - Country:US
Mailing Address - Phone:660-886-7431
Mailing Address - Fax:660-886-9001
Practice Address - Street 1:2305 SOUTH 65 HIGHWAY
Practice Address - Street 2:BUILDING A
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-3702
Practice Address - Country:US
Practice Address - Phone:660-886-7800
Practice Address - Fax:660-831-3328
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010019790207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOG8000005Medicare PIN