Individual
JOEL Q PEAVYHOUSE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
417 NORTHCREST DR, SPRINGFIELD, TN 37172-3973
(615) 382-5204
(615) 382-4952
Mailing address
417 NORTHCREST DR, SPRINGFIELD, TN 37172-3973
(615) 382-5204
(615) 382-4952
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD6335
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3165033
—
TN
01
—
4060714
TENNCARE BCBS
TN
Enumeration date
09/12/2005
Last updated
07/08/2007
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