Individual
MR. CHARLES ROYCE PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
92 BETTYS CREEK RD, DILLARD, GA 30537-2257
(706) 746-6571
(706) 746-5643
Mailing address
PO BOX 444, DILLARD, GA 30537-0444
(706) 746-6571
(706) 746-5643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
025380
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000273831G
—
GA
05
—
000649822A
—
GA
01
—
1134316219
R H FACILITY
GA
Enumeration date
08/24/2006
Last updated
02/24/2025
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