Individual
DR. DAVID J PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
211 E MAIN ST, CARBONDALE, KS 66414-9607
(785) 836-7111
(785) 836-9251
Mailing address
211 E MAIN ST, CARBONDALE, KS 66414-9607
(785) 836-7111
(785) 836-9251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-24443
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067059
MEDICARE PTAN
KS
05
—
100159180B
—
KS
Enumeration date
06/08/2006
Last updated
06/09/2014
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