Individual
DR. MARK PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11130 KINGSTON PIKE STE 7&8, FARRAGUT, TN 37934-2865
(865) 675-1953
Mailing address
1275 DICK LONAS RD UNIT 101, KNOXVILLE, TN 37909-1383
(865) 584-4747
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4412
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/01/2017
Last updated
07/21/2021
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