Individual
ROY DAVID PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 249-1166
Mailing address
1014 CEDAR LN, SUMMIT, MS 39666-5103
(601) 324-9403
(601) 936-0686
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
13496
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00112194
—
MS
01
—
050078275
MEDICARE RAILROAD
MS
Enumeration date
08/23/2006
Last updated
02/14/2017
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