| Doctor Name: | RICHARD ANTHONY PECKHAM |
| NPI Number: | 1174964357 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | RN162464 |
| Business Practice Address: | 3015 Veterans Pkwy S Moultrie, GA - 317886705 |
| Business Phone Number: | 2299854815 |
| Business Fax Number: | 2298906777 |
| Mailing Address: | 817 Prince Ave, TIFTON |
| State: | GA |
| Postal Code: | 317944053 |
| Phone Number: | 2293762859 |
| Fax Number: | |
| NPI Enumeration Date: | 07/16/2013 |
| NPI Last Update Date: | 07/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | RN162464 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |