Peacock, Ivan Y
Peacock, Ivan Y is an individual health care provider with primary practice located at 131 Roundabout Ct , Rocky Mount NC 27804-3573. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Peacock, Ivan Y can be contacted via phone (252) 443-4024.Contact Information
Primary practice address
131 Roundabout Ct
Rocky Mount NC 27804-3573
Phone: (252) 443-4024
Fax: (252) 443-5021
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 28299 | North Carolina |
Profile Details
| NPI number | 1831190669 |
|---|---|
| LBN Legal business name | Peacock, Ivan Y |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2005 |
| Last updated | Mar 7th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831190669 | NPPES |
| North Carolina | MEDICAID | 89-66375 |
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