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Individual

JAMES PEACOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-5000
(603) 640-1228
Mailing address
10 ORMS ST, SUITE 110, PROVIDENCE, RI 02904-2228
(401) 453-0666
(401) 453-9619

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
N30848
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
082165-23
NH
367500000X
Certified Registered Nurse Anesthetist
255585
MA
367500000X
Certified Registered Nurse Anesthetist
RNA36627
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001803
BLUE CHIP PROVIDER NUMBER
RI
01
1286
BLUE CROSS PROVIDER NUMBER
RI
01
1306892062
FALLON
MA
Enumeration date
05/25/2006
Last updated
05/17/2026
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