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Individual

DEREK J PEACOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1305 FOWLER ST STE 1D, RICHLAND, WA 99352-4719
(509) 940-2284
Mailing address
1305 FOWLER ST STE 1D, RICHLAND, WA 99352-4719
(509) 940-2284

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD00036578
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0152619
L&I
WA
01
660003458
MEDICARE RR
WA
05
8477630
WA
Enumeration date
06/30/2005
Last updated
09/18/2025
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