Individual
DR. JEFFREY ALAN PENMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3920 ST FRANCIS WAY, SUITE 100, LAFAYETTE, IN 47905-4917
(765) 428-5888
(765) 428-5896
Mailing address
3920 ST FRANCIS WAY, SUITE 100, LAFAYETTE, IN 47905-4917
(765) 428-5888
(765) 428-5896
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01036681A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10007090940
—
IN
Enumeration date
07/09/2006
Last updated
02/17/2016
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