Individual
JOSHUA CHANDLER PENNIMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 WALLACE BLVD, AMARILLO, TX 79106-1799
(806) 212-2129
(806) 212-2246
Mailing address
PO BOX 840026, DALLAS, TX 75284-0026
(806) 212-5079
(806) 212-6278
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
S8233
TX
208M00000X
Hospitalist Physician
Primary
S8233
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1R0976
MEDICARE
TX
05
—
425180301
—
TX
Enumeration date
04/19/2018
Last updated
08/23/2021
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