Individual
DILLON PENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 N L ROGERS WELLS BLVD, GLASGOW, KY 42141-1300
(270) 659-5555
Mailing address
170 WINTER PARK PL, ELIZABETHTOWN, KY 42701-8396
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R4843
KY
207Q00000X
Family Medicine Physician
Primary
55213
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100603490
—
KY
01
—
K300041
MEDICARE
KY
Enumeration date
04/17/2018
Last updated
03/10/2023
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