| Jack W Pennington Md Llc | |
|
207 Hospital Cir Suite A Blairsville GA 30512-3128 | |
| (706) 745-5758 | |
| (706) 745-1211 |
| Full Name | Jack W Pennington Md Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 207 Hospital Cir, Blairsville, Georgia |
| Authorized Official Name and Position | Jack W Pennington (PHYSICIAN/OWNER) |
| Authorized Official Contact | 7067455758 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack W Pennington Md Llc 207 Hospital Cir Suite A Blairsville GA 30512-3128 Ph: (706) 745-5758 | Jack W Pennington Md Llc 207 Hospital Cir Suite A Blairsville GA 30512-3128 Ph: (706) 745-5758 |
| NPI Number | 1851561492 |
|---|---|
| Provider Enumeration Date | 03/11/2008 |
| Last Update Date | 03/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851561492 | NPI | - | NPPES |
| 89066U5 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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