Organization
ROBERT ELDEN PENNINGTON MD, PHD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT PENNINGTON M.D., PHD (PHYSICIAN OWNER)
(505) 625-5512
Entity
Organization
Contact information
Practice address
1 EL ARCO IRIS DR, ROSWELL, NM 88201-7711
(505) 625-5512
(505) 625-1013
Mailing address
1 EL ARCO IRIS DR, ROSWELL, NM 88201-7711
(505) 625-5512
(505) 625-1013
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
95321
NM
208VP0000X
Pain Medicine Physician
95321
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72080
—
NM
Enumeration date
10/17/2007
Last updated
10/17/2007
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