Bruce L Pennington, MD | |
100 Jackson Pike, Gallipolis, OH 45631-1560 | |
(740) 446-5289 | |
(740) 446-5697 |
Full Name | Bruce L Pennington |
---|---|
Gender | Male |
Speciality | Diagnostic Radiology |
Experience | 38 Years |
Location | 100 Jackson Pike, Gallipolis, Ohio |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396785424 | NPI | - | NPPES |
0118365000 | Medicaid | WV | |
000000007285 | Other | ANTHEM BCBS | |
000000193002 | Other | OH | UNISON MEDICAID |
001714061 | Other | MOUNTAIN STATE BCBS | |
0798650 | Other | OH | MOLINA MEDICAID |
300028175 | Other | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 16694 (West Virginia) | Secondary |
2085R0202X | Radiology - Diagnostic Radiology | 35-06-0247 (Ohio) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Holzer Medical Center | Gallipolis, OH | Hospital |
Holzer Medical Center Jackson | Jackson, OH | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Holzer Clinic Llc | 5890606008 | 264 |
Holzer Clinic Llc | 5890606008 | 264 |
Entity Name | Holzer Clinic Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508817248 PECOS PAC ID: 5890606008 Enrollment ID: O20040517000510 |
Mailing Address | Practice Location Address |
---|---|
Bruce L Pennington, MD 90 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5289 | Bruce L Pennington, MD 100 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5289 |
Steven D. Conley, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 855-446-5937 Fax: 740-446-5697 | |
Subhash Khosla, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 170 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5129 Fax: 740-446-5622 | |
David B. Price, D.O. Radiology Medicare: Not Enrolled in Medicare Practice Location: 90 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5289 Fax: 740-446-5697 | |
Manual A. Casanova, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 90 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5709 Fax: 740-446-5697 | |
Dr. Kevin M. Mccann, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 90 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5890 Fax: 740-446-5532 | |
Dr. Nicholas Mcdonald, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5000 Fax: 740-446-5697 |