Individual
EUGENE FRANK PENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 CLINIC AVE, SUITE 101, CARROLLTON, GA 30117-4401
(770) 834-0873
(770) 834-6118
Mailing address
150 CLINIC AVE, SUITE 101, CARROLLTON, GA 30117-4401
(770) 834-0873
(770) 834-6118
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
055277
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
616550092A
—
GA
Enumeration date
04/28/2006
Last updated
06/24/2013
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