Individual
DR. LAROY PETE PENIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 CLEVELAND AVE, SUITE 100, EAST POINT, GA 30344-3602
(404) 766-4760
(404) 766-4702
Mailing address
1667 NISKEY LAKE RD SW, ATLANTA, GA 30331-6401
(404) 344-3142
(404) 344-9263
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
49080
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00886894A
—
GA
Enumeration date
09/28/2006
Last updated
07/08/2007
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