Richard Worth Peckham, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R3207 Issued in AR

Practice address

715 N College Ave
El Dorado, AR 71730-4403

Phone

(870) 862-7921

Fax

(870) 864-2490

NPI assigned

Aug 19, 2005

Last updated

Nov 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1750373395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 N VINE",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532842",
            "telephone_number": "870-234-7500",
            "fax_number": "870-234-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N COLLEGE AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304403",
            "telephone_number": "870-862-7921",
            "fax_number": "870-864-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKHAM",
        "first_name": "RICHARD",
        "middle_name": "WORTH",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "R3207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107709001/152144002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in El Dorado, AR
• Providers in El Dorado, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.