# DR. JEFFREY CARL PENCE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1629063722
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | 0101277715 | VA | — |
| 2086S0120X | Pediatric Surgery Physician | 2086S0120X | GA | Yes |
| 2086S0120X | Pediatric Surgery Physician | 35.092404 | OH | — |
| 2086S0120X | Pediatric Surgery Physician | 9500178 | NC | — |

## Other

- **Enumeration date:** 09/14/2005
- **Last updated:** 07/25/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 12334 | BCBS NC | NC |
| 05 | — | 2881645 | — | OH |
| 01 | — | 370015118 | RAILROAD MEDICARE | NC |
| 05 | — | 8912334 | — | NC |