Individual
DR. CLAYTON WILLIAM PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2423
(706) 721-6918
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
6905
GA
207W00000X
Ophthalmology Physician
Primary
DR.0060612
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029071
KAISER COMMERCIAL NUMBER
CO
05
—
9000167500
—
CO
Enumeration date
06/23/2014
Last updated
05/20/2020
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