Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jonathan Dale Peckham

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1992130884

Jonathan Dale Peckham is a Student in an Organized Health Care Education/Training Program in Phoenix, Arizona. Practices as a sole proprietor. Registered with an NPI since 2013.

In the registry since
2013

Practice location Address checks out

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone: (602) 344-5445
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1992130884
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 10, 2013
Last updated in NPPESApril 1, 2026
Certification dateApril 1, 2026

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