NPI 1104146224

Roland Lee Peckham

Practitioner Student in an Organized Health Care Education/Training Program Fort Gordon, GA

Practice location

Address: 300 W Hospital Rd, Fort Gordon, GA 30905-5741
Phone: (513) 519-9281
Mailing address: 4517 Castle Rock Rd, Augusta, GA 30909-4002

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Georgia →

Registry record

NPI: 1104146224
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jun 2010
Record last updated: 11 Jun 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.