Individual
AMANDA PEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
3379 OSBORNE PL, MACON, GA 31204-1901
(478) 390-4141
Mailing address
PO BOX 27435, MACON, GA 31221-7435
(478) 474-2200
(478) 314-0740
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
171063
GA
Other
Enumeration date
11/03/2016
Last updated
07/18/2023
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