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1063548964
CHARLES LEROY PEACOCK
LAWRENCEVILLE, GA
NPI
1063548964
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: GA RN182133 CRNA)
Enumeration Date
2007-02-26
Last Update Date
2007-07-08
Business Address
Mr. CHARLES LEROY PEACOCK CRNA
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30045-7694
Phone number: 678-442-4321
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Mailing Address
Mr. CHARLES LEROY PEACOCK CRNA
840 CONNELL LN
LAWRENCEVILLE, GA 30044-6123
Phone number: 770-736-5173
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