Individual provider · Type 1 NPI

Roland Lee Peckham Jr.

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

NPI number 1104146224 Active

Practice location

300 W Hospital Rd
Fort Gordon, GA 30905-5741

Call (513) 519-9281 Map

Mailing address

4517 Castle Rock Rd
Augusta, GA 30909-4002

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1104146224

Roland Lee Peckham Jr.'s National Provider Identifier is 1104146224, issued on Jun 11, 2010. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fort Gordon, GA. The record was last updated on Jun 11, 2010.