Individual
MARSHA K PENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
715 SHAKER DR, STE 120, LEXINGTON, KY 40504
(859) 278-8443
(859) 278-6325
Mailing address
715 SHAKER DR, STE 120, LEXINGTON, KY 40504
(859) 278-8443
(859) 278-6325
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
22793
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000068914
BLUE CROSS BLUE SHIELD
KY
05
—
64227936
—
KY
Enumeration date
05/23/2006
Last updated
11/20/2007
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