Individual
DR. MICHAEL TRISTAN PEAVEY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1311 ASTON AVE, MCCOMB, MS 39648-2825
(601) 684-2481
(601) 684-2488
Mailing address
PO BOX 490, MCCOMB, MS 39649-0490
(601) 250-4366
(601) 250-4367
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
14452
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122130
—
MS
Enumeration date
10/05/2006
Last updated
08/25/2022
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