Individual
MR. ROBERT LEE PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
998 S HIGHWAY 25 W, WILLIAMSBURG, KY 40769-1692
(606) 549-8154
Mailing address
PO BOX 506, JELLICO, TN 37762-0506
(606) 549-8154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
46230
TN
207Q00000X
Family Medicine Physician
Primary
TP430
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100134910
—
KY
Enumeration date
05/04/2006
Last updated
03/14/2011
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