Organization
E. EARL PENNINGTON, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD EARL PENNINGTON MD (PHYSICIAN/MANAGER)
(678) 954-8538
Entity
Organization
Contact information
Practice address
3890 JOHNS CREEK PKWY, SUITE 360, SUWANEE, GA 30024-1284
(678) 954-8538
(770) 244-9204
Mailing address
3890 JOHNS CREEK PKWY, SUITE 360, SUWANEE, GA 30024-1284
(678) 954-8538
(770) 244-9204
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
015299
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00098084B
—
GA
Enumeration date
12/11/2013
Last updated
12/11/2013
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