Individual
DANNY R PENICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 269-0000
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
R9G70
MO
207RI0011X
Interventional Cardiology Physician
Primary
R9G70
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107050
BLUE CROSS/BLUE SHIELD
—
05
—
202931028
—
MO
Enumeration date
06/15/2006
Last updated
10/12/2022
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