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Organization
WILLIAM PEACOCK
Active
Organization
WILLIAM PEACOCK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM STAN PEACOCK OD (OWNER)
(850) 526-0067
Entity
Organization
Contact information
Practice address
2255 HIGHWAY 71, MARIANNA, FL 32448-2541
(850) 526-0067
(850) 526-0069
Mailing address
2255 HIGHWAY 71, MARIANNA, FL 32448-2541
(850) 526-0067
(850) 526-0069
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1999
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPC1999
OPTOMETRY BRANCH LICENSE
FL
Enumeration date
10/30/2014
Last updated
06/10/2016
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