Peacock, Derek J

Peacock, Derek J is an individual health care provider with primary practice located at 6710 W Okanogan Pl Kadlec Clinic Rheumatology, Kennewick WA 99336. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Peacock, Derek J can be contacted via phone (509) 942-2528.

Contact Information

Primary practice address
6710 W Okanogan Pl Kadlec Clinic Rheumatology Kennewick WA 99336
Phone: (509) 942-2528
Fax: (509) 783-2008
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X MD00036578 Washington

Profile Details

NPI number 1720085038
LBN Legal business name Peacock, Derek J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated Jun 23rd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720085038 NPPES
Washington Other 0152619 L&I
Washington MEDICAID 8477630 L&I
Washington Other 660003458 L&I

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