Individual
DR. EDWARD M PENICK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5300 W MARKHAM ST, LITTLE ROCK, AR 72205-3528
(501) 664-5354
(501) 664-5257
Mailing address
5300 W MARKHAM ST, LITTLE ROCK, AR 72205-3528
(501) 664-5354
(501) 664-5257
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
E-4798
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160765001
—
AR
01
—
P00337243
RAILROAD MEDICARE
AR
Enumeration date
05/31/2006
Last updated
08/13/2024
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