Individual
SCOTT PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 REID PARKWAY, ANESTHESIA/SURGERY DEPARTMENT, RICHMOND, IN 47374-1157
(765) 935-8807
(765) 983-3219
Mailing address
1100 REID PARKWAY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 983-3127
(765) 983-3219
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01042814
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000754101
ANTHEM
IN
05
—
0991217
—
OH
05
—
100461850
—
IN
Enumeration date
07/08/2005
Last updated
11/15/2013
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