Organization
CHRISTOPHER F. PENKA, M.D., P.A., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER F. PENKA M.D. (PHYSICIAN SURGEON)
(801) 387-6520
Entity
Organization
Contact information
Practice address
4403 HARRISON BLVD STE 1815, OGDEN, UT 84403-3271
(801) 387-6520
(801) 387-6557
Mailing address
4403 HARRISON BLVD STE 1815, OGDEN, UT 84403-3271
(801) 387-6520
(801) 387-6557
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
811667271205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
556809063000
—
UT
Enumeration date
06/19/2007
Last updated
08/22/2020
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