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General NPI Number Information
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NPI Number | 1033566534
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Entity Type | Individual
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Provider Name | JEFFREY PEACOCK
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Gender | Male
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 2500 E HUNT DR STE H-J
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City | SHOW LOW
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State | AZ
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Zip | 85901-7954
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Country | US
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Telephone | 928-537-6937
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Fax | 928-532-8798
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Provider Business Mailing Address
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Address Line | 2500 E HUNT DR STE H-J
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City | SHOW LOW
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State | AZ
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Zip | 85901-7954
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Country | US
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Telephone | 928-537-6947
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Fax | 928-532-8798
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 42458
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 98422
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | MD.42458
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License Number State | AL
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