Individual
MARY KATHRYN PEABODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10730 MEDLOCK BRIDGE RD, JOHNS CREEK, GA 30097-2637
(404) 948-4073
Mailing address
PO BOX 628231 MAIL CODE: 5068, ORLANDO, FL 32862-8231
(678) 344-8900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
10377
GA
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
04/29/2021
Last updated
12/12/2022
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