Organization
COLON AND RECTAL SURGERY CONSULTANTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE J PENNINGTON M.D. (PRESIDENT)
(423) 610-1177
Entity
Organization
Contact information
Practice address
1321 SUNSET DR, SUITE 22, JOHNSON CITY, TN 37604-3698
(423) 610-1177
(423) 610-1179
Mailing address
1321 SUNSET DR, SUITE 22, JOHNSON CITY, TN 37604-3698
(423) 610-1177
(423) 610-1179
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD0000030358
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3370584
—
TN
Enumeration date
05/18/2007
Last updated
04/20/2008
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