Individual
DR. STEPHANIE MARIE PENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-1900
(602) 933-1918
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-0008
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
48909
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
981048
—
AZ
01
—
P00369753
RAILROAD MEDICARE
MI
01
—
SP082178
BCBS
MI
Enumeration date
07/22/2006
Last updated
08/15/2023
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