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Individual

LOVERD MICHAEL PEACOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-5148
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-5148

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
C-4409
AR
2085R0203X
Therapeutic Radiology Physician
Primary
C-4409
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
115749001
AR
01
52827
BCBS INDIVIDUAL
AR
01
CAQH
11476043
AR
Enumeration date
05/17/2006
Last updated
07/18/2016
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