Healthcare Provider Details

I. General information

NPI: 1790706786
Provider Name (Legal Business Name): MOLLY MCPEAKE PEELER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 19TH ST STE 701
KNOXVILLE TN
37916-1853
US

IV. Provider business mailing address

501 19TH ST STE 701
KNOXVILLE TN
37916-1853
US

V. Phone/Fax

Practice location:
  • Phone: 865-524-3208
  • Fax: 865-522-4322
Mailing address:
  • Phone: 865-524-3208
  • Fax: 865-522-4322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number16336
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: