John M. Peasant Sr., M.D.

Individual provider Active NPI Family Medicine Physician · Clayton, AL

NPI 1376729319 · NPPES record last updated Jan 19, 2008

Key facts

NPI
1376729319
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
6600 (AL)
Practice address
379 Highway 239
Clayton, AL 36016-4618
Phone
(334) 775-3610
Fax
(334) 775-3610
NPI assigned
Jan 19, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6600ALMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6600 AL Yes

Addresses

Primary practice location

379 Highway 239
Clayton, AL 36016-4618

Mailing address

379 Highway 239
Clayton, AL 36016-4618
Phone (334) 775-3610

Other providers in Clayton, AL

All providers in Clayton, AL · Family Medicine Physician in Alabama

Sources for this page

Verify at the official NPI Registry.