Larue D Penny JR. M.D.

NPI 1023099942 - Pediatrics - 208000000X

NPI Details
NPI 1023099942
Gender Male
Enumeration Date 11/08/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
3400 OLD MILTON PKWY
SUITE 330/BLDG A
ALPHARETTA GA, 30005-3707, US
Phone (770) 751-6111
Fax
Business Location
916 RAVENWOOD WAY
CANTON GA, 30115-6421, US
Phone (770) 664-2406
Fax
Toxanomy
Taxonomy Code 208000000X
License State Georgia
License Number 049718
Remove 1023099942 NPI Number
 

According to our database, Dr. Larue D Penny JR. M.D. NPI is 1023099942, taxonomy code is 208000000X and license number is 049718, license state is located at Georgia. Larue D Penny JR. M.D. physically located at 3400 Old Milton Pkwy, Alpharetta GA, 30005-3707. NPI Number Larue D Penny JR. M.D. has the Individual type.

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1023099942 NPI number is provided on an as is basis without warranty of any kind. 1023099942 is maintained by the National Plan & Provider Enumeration System. The contents of Larue D Penny JR. M.D. are for informational purposes only.