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Individual

MR. VINCENT A PENNIPEDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
10120 W 119TH ST, OVERLAND PARK, KS 66213
(913) 339-9090
(913) 339-6417
Mailing address
10120 W 119TH ST, OVERLAND PARK, KS 66213
(913) 339-9090
(913) 339-6417

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1227
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1437218484
AETNA
KS
01
20169013
BCBS KANSAS CITY
KS
Enumeration date
12/06/2006
Last updated
04/20/2009
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