Individual
DR. JOEL L. PENEGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1007 SKYWAY DR, MONROE, NC 28110-3050
(704) 289-1547
(704) 291-9441
Mailing address
PO BOX 207261, DALLAS, TX 75320-7261
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0933
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09703
BLCROSS
NC
05
—
8909703
—
NC
Enumeration date
11/02/2007
Last updated
02/11/2022
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