Individual
CIANNA PENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 MIMOSA DR, THOMASVILLE, GA 31792-6676
(229) 226-8881
(229) 584-5964
Mailing address
100 MIMOSA DR, THOMASVILLE, GA 31792-6676
(229) 226-8881
(229) 584-5964
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
76648
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2151193
—
LA
Enumeration date
03/31/2011
Last updated
08/05/2020
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