Provider Demographics
NPI:1669563649
Name:PEYTON, ERWIN HARRY JR (MD)
Entity type:Individual
Prefix:
First Name:ERWIN
Middle Name:HARRY
Last Name:PEYTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1095 OLIVER DR
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35904-9363
Mailing Address - Country:US
Mailing Address - Phone:256-547-6969
Mailing Address - Fax:256-547-4076
Practice Address - Street 1:601 S 4TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5218
Practice Address - Country:US
Practice Address - Phone:256-547-6969
Practice Address - Fax:256-547-4076
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL08115207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC72698Medicare UPIN