Organization
KERRY PENNINGTON, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY F PENNINGTON M.D. (PRESIDENT)
(870) 226-6754
Entity
Organization
Contact information
Practice address
1012 E CHURCH ST, SUTIE A, WARREN, AR 71671-3509
(870) 226-6754
(870) 226-7925
Mailing address
1012 E CHURCH ST, SUTIE A, WARREN, AR 71671-3509
(870) 226-6754
(870) 226-7925
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C5438
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110722002
—
AR
05
—
133563762
—
AR
01
—
5B909
BCBS PROVIDER #
AR
Enumeration date
02/23/2006
Last updated
05/21/2008
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