Kenneth L Pennington
Medical Oncology
200 High Park Ave
Goshen
, Indiana 46526-4810
Kenneth L Pennington
Medical Oncology
200 High Park Ave
Goshen
, Indiana 46526-4810
(574) 364-2759
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About
Features
Specialties
- Medical Oncology
Languages spoken
- English
Location
First Address
- Kenneth L Pennington
- 3702 New Vision Dr Bldg B
- Fort Wayne, IN
- Zip : 46845-1703
- Fax : (574) 364-2759
- Phone : (260) 266-8210
Second Address
- Kenneth L Pennington
- 200 High Park Ave
- Goshen, IN
- Zip : 46526-4810
- Phone : (574) 535-2888
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RX0202X | Medical Oncology | 01024970A | IN |
National Provider Identifier
| NPI | 1144200684 |
|---|---|
| Provider Name | Kenneth L Pennington |
| First Address | Fort Wayne, IN 46845-1703 |
| Second Address | Goshen, IN 46526-4810 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/01/2006 |
| Last Update Date | 11/03/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 100138820 | (05) | IN |
| E05837 | (02) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.