Peacock, Kevin H

Peacock, Kevin H is an individual health care provider with primary practice located at 1501 Milstead Rd Ne Suite 110, Conyers GA 30012-3838. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Medical Oncology, Allopathic & Osteopathic Physicians / Hematology & Oncology, Allopathic & Osteopathic Physicians / Hematology. Allopathic & Osteopathic Physicians / Hematology & Oncology is his primary health care specialty. Peacock, Kevin H can be contacted via phone (770) 760-9949.

Contact Information

Primary practice address
1501 Milstead Rd Ne Suite 110 Conyers GA 30012-3838
Phone: (770) 760-9949
Fax: (770) 760-9951
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 200400941 North Carolina
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 064241 Georgia
Allopathic & Osteopathic Physicians / Hematology 207RH0000X 2004-00941 North Carolina

Profile Details

NPI number 1679686661
LBN Legal business name Peacock, Kevin H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2006
Last updated Mar 9th, 2021 - about 4 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 1679686661 NPPES
South Carolina MEDICAID Q0094F
South Carolina MEDICAID 3810009045
South Carolina MEDICAID 119857791A
South Carolina MEDICAID 5905021
South Carolina Other 7119766
South Carolina Other 808364
South Carolina Other 145JC
South Carolina MEDICAID 1679686661
South Carolina Other 199212

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