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Organization
DRS. PEACOCK & RAFOTH, P.C.
Active
Organization
DRS. PEACOCK & RAFOTH, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAIRE SHIVERS (PRACTICE ADMINISTRATOR)
(706) 860-8228
Entity
Organization
Contact information
Practice address
3634 WHEELER RD, AUGUSTA, GA 30909-6518
(706) 860-8228
(706) 860-7222
Mailing address
3634 WHEELER RD, AUGUSTA, GA 30909-6518
(706) 860-8228
(706) 860-7222
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN007367
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
889584
UNITED CONCORDIA
—
Enumeration date
06/20/2006
Last updated
08/22/2020
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