Mark Eugene Peacock in Augusta - Periodontics
Mark Eugene Peacock - NPI 1578652616
Mark Eugene Peacock is a Periodontics in Augusta, Georgia. Mark Eugene Peacock practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Mark Eugene Peacock is 1578652616. The last update date is 2023-04-13.
Mark Eugene Peacock's current location address is 1430 John Wesley Gilbert Drive Gc-1012, Augusta, Georgia. You can contact this provider via phone number 7067217913. The mailing address for Mark Eugene Peacock is 1430 John Wesley Gilbert Drive Gc-1012, Augusta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Eugene Peacock |
|---|---|
| Address | 1430 John Wesley Gilbert Drive Gc-1012, Augusta, Georgia |
| Phone Number | 7067217913 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DMD, MS |
NPI Number Detail
| NPI Number | 1578652616 |
|---|---|
| Provider Enumeration Date | 2006-10-12 |
| Last Updated Date | 2023-04-13 |
Provider Mailing Address Detail
| Address | 1430 John Wesley Gilbert Drive Gc-1012 |
|---|---|
| City | Augusta |
| State | Georgia (GA) |
| Post Code | 309123238 |
| Phone Number | 7067217913 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | DNCS000384 |
|
Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| ZX3246 | SC | -- | |
| 003131974B | GA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Mark Eugene Peacock by the Centers for Medicare & Medicaid Services?
The Mark Eugene Peacock has been assigned the NPI (National Provider Identifier) 1578652616 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Mark Eugene Peacock is physically located?
The Mark Eugene Peacock is physically situated at the following address: 1430 John Wesley Gilbert Drive Gc-1012, Augusta, GA, 309123238.
What is Mark Eugene Peacock's area of expertise and its corresponding taxonomy classification?
The Mark Eugene Peacock's field of specialization is Periodontics, and it falls under the taxonomy code 1223P0300X, which categorizes healthcare providers based on their areas of practice.
On what date did Mark Eugene Peacock receive its 1578652616 assignment from the Centers for Medicare & Medicaid Services?
The Mark Eugene Peacock was assigned its 1578652616 on 2006-10-12, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Mark Eugene Peacock most recently updated or revised?
The information pertaining to Mark Eugene Peacock, including its address, specialty, and other relevant details, was last updated or revised on 2023-04-13.
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