Organization
PENNINGTON FACIAL PLASTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDSEY PENNINGTON MD (SOLE MBR)
(505) 715-3338
Entity
Organization
Contact information
Practice address
345 DREXEL DR, SHREVEPORT, LA 71106-2305
(505) 715-3338
Mailing address
345 DREXEL DR, SHREVEPORT, LA 71106-2305
(505) 514-2609
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
205826
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2144464
—
LA
Enumeration date
05/24/2017
Last updated
05/24/2017
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