# MR. MARK KEVIN PEEBLES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1275743841
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 1629 | OK | — |
| 363A00000X | Physician Assistant | 2011011364 | MO | Yes |

## Other

- **Enumeration date:** 05/23/2007
- **Last updated:** 05/04/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1076290 | BOARD CERTIFICATION | MO |
| 01 | — | 26D0889777 | CLIA | MO |
| 05 | — | PENDING | — | MO |