Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | 35.055319 | OH |
Y | 208200000X | Surgeon | 35.055319 | OH |
Y | 208600000X | Surgeon | 35.055319 | OH |
NPI | 1093892325 |
---|---|
Provider Name | Gary A. Pennington |
First Address | Akron, OH 44333-1763 |
Second Address | Akron, OH 44333-1763 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 01/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
240006022 | RAILROAD MEDICARE (01) | |
927788 | (05) | OH |
F06593 | (02) |