Peck, David Robert

Peck, David Robert is an individual health care provider with primary practice located at 852 Dacula Rd , Dacula GA 30019. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Peck, David Robert can be contacted via phone (770) 848-6190.

Contact Information

Primary practice address
852 Dacula Rd Dacula GA 30019
Phone: (770) 848-6190
Fax: (770) 848-5367
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 005607 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1660 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 005607 Georgia

Profile Details

NPI number 1063663326
LBN Legal business name Peck, David Robert
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2008
Last updated Dec 6th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063663326 NPPES
Georgia MEDICAID 613680228B

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