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General NPI Number Information
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NPI Number | 1437223054
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Entity Type | Individual
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Provider Name | JOEL HEWITT LEFEVRE PEACOCK MD
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Gender | Male
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 12250 E ILIFF AVE #300
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City | AURORA
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State | CO
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Zip | 80014-6318
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Country | US
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Telephone | 303-306-4321
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Fax | 720-524-1551
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Provider Business Mailing Address
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Address Line | 1550 S POTOMAC ST STE 110
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City | AURORA
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State | CO
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Zip | 80012-5433
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Country | US
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Telephone | 303-306-4321
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Fax | 720-524-1551
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 29776
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License Number State | CO
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