Individual
DR. JEFFREY PENMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
505 W 400 N, OREM, UT 84057-1950
(801) 714-3450
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10410184-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD6108
—
AK
Enumeration date
07/18/2006
Last updated
03/13/2018
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