Individual
JEFFREY R PENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 514-2529
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-1212
ID
Other
Enumeration date
04/28/2017
Last updated
06/08/2020
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