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Organization

PENN TECK DIAGNOSTICS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WEEMS R PENNINGTON JR. MD (PRESIDENT)
(706) 722-6612
Entity
Organization

Contact information

Practice address
820 ST. SEBASTIAN WAY,, SUITE 2B, AUGUSTA, GA 30901
(706) 722-6612
(706) 722-5057
Mailing address
820 ST. SEBASTIAN WAY,, SUITE 2B, AUGUSTA, GA 30901
(706) 722-6612
(706) 722-5057

Taxonomy

Speciality
Code
Description
License number
State
207UN0901X
Nuclear Cardiology Physician
Primary
014977
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00094179C
GA
05
GPA518
SC
Enumeration date
09/28/2006
Last updated
05/26/2011
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