Individual
DR. MARK EUGENE PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912-3238
(706) 721-2441
Mailing address
1430 JOHN WESLEY GILBERT DRIVE GC-1012, AUGUSTA, GA 30912-3238
(706) 721-7913
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN013245
GA
1223P0300X
Periodontics
DNCS000384
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003131974B
—
GA
05
—
ZX3246
—
SC
Enumeration date
10/12/2006
Last updated
02/19/2026
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