Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | R4524 | AR |
Y | 208600000X | Surgeon | R4524 | AR |
NPI | 1013004522 |
---|---|
Provider Name | Mr. Guy L. Peeples |
First Address | Harrison, AR 72601-1116 |
Second Address | Harrison, AR 72601-2952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 17/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123444001 | (05) | AR |
C70936 | (02) | |
C7096 | (02) | AR |