Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. GRANT ALLEN PEACOCK III, PT
Active Sole ProprietorSpecialist · TUCKER, GA
Registration Details
- NPI Number
- 1942411699
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 24, 2007 (18.941225016448 yrs)
- Last Updated
- Jul 8, 2007
- License
-
PT001863 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2627 CHURCHWELL LNTUCKER, GA, 300842412Browse GA providers · Browse ZIP 30084
- Phone
- 7704918511
- Fax
- 7704916914
- Primary Specialty
-
Specialist
174400000X
Other Specialist Providers in TUCKER, GA
| Name | Credential | NPI |
|---|---|---|
| DR. RALPH ROBERT BETON | MD | 1932100609 |
| DAMIEN ANTOINE DOUTE | MD | 1033106158 |
| ALVARO J LOPEZ | M.D. | 1861440216 |
| DR. JERRY LEE COOPER | MD | 1710080627 |
| DR. JAMES ENOCH DOPSON | M.D. | 1285732495 |
| HANIF BOGHANI | MD | 1619026150 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.