DR. MD Kevin H Peacock, NPI 1679686661
Hematology & Oncology Physician in Conyers, GA, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1679686661 |
| NPI Entity Type | Individual |
| Provider Name | DR. MD Kevin H Peacock |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Certification Date | September 30, 2009 |
| Provider Location Address | 1501 Milstead Rd Ne, Suite 110, Conyers, GA, US |
| Provider Mailing Address | 1835 Savoy Dr, Suite 300, Atlanta, GA, US, 303411072 |
| Gender | Male |
| Is Sole Proprietor? | No |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Hematology & Oncology Physician |
| Classification | |
| Group | |
| License No. | 064241 |
| License State | GA |
| Description | An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| 200400941 | NC | No | |||
| 2004-00941 | NC | No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| Q0094F | SC | MEDICAID | 05 |
| 3810009045 | WV | MEDICAID | 05 |
| 119857791A | GA | MEDICAID | 05 |
| 5905021 | NC | MEDICAID | 05 |
| 7119766 | NC | AETNA | 01 |
| 808364 | NC | PARTNERS | 01 |
| 145JC | NC | BCBS | 01 |
| 1679686661 | VA | MEDICAID | 05 |
| 199212 | NC | MEDCOST | 01 |
Health Information Exchange
| Endpoint Type | Endpoint | Description | Use | Content Type | Affiliation | Location |
|---|---|---|---|---|---|---|
| DIRECT | [email protected] | direct messaging | DIRECT | OTHER | No | 1501 Milstead Rd NE, Suite 110, Conyers, GA, US |
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