Individual
DR. JEFFREY EDWARD PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 MILLER ST STE I, WINSTON SALEM, NC 27104-4206
(336) 277-2225
(336) 227-2231
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 277-2225
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2012-00459
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
2012-00459
NC
208VP0000X
Pain Medicine Physician
Primary
2012-00459
NC
208VP0014X
Interventional Pain Medicine Physician
2012-00459
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2012-00459
NC MED LICENSE
NC
05
—
NC1806
—
SC
Enumeration date
06/17/2008
Last updated
03/07/2023
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