Individual
JOHN L PENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
750 N SYRINGA ST, STE 205, POST FALLS, ID 83854-5275
(208) 262-0945
(208) 415-0150
Mailing address
750 N SYRINGA ST, STE 205, POST FALLS, ID 83854-5275
(208) 262-0945
(208) 415-0150
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M-6485
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020050503
RAILROAD MEDICARE
ID
Enumeration date
05/25/2006
Last updated
04/14/2025
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