James Peacock, CSAC, ICS

NPI 1588119887 · on the registry since 2016

Practice

Address: 36745 Aiken Rd
Bayfield, WI 54814
Phone: (715) 779-3707
Fax: (715) 779-3362
Organisation at this address: Red Cliff Band Of :Ake Superior
Red Cliff Band Of Lake Superior Chippewa Indians
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 12

Registry record

Primary taxonomy: 101YA0400X
101YA0400X
Also registered as: 101YM0800X
Licence states on file: WI
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2019-05-01

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin