Willie A Pennick MD

NPI 1568426302 - Family Medicine - 207Q00000X

NPI Details
NPI 1568426302
Gender Male
Enumeration Date 04/17/2006
Last Updated 07/02/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
1760 EDGEWOOD AVE W
SUITE B
JACKSONVILLE FL, 32208-7209, US
Phone (904) 358-8480
Fax (904) 358-8460
Business Location
1760 EDGEWOOD AVE W
SUITE B
JACKSONVILLE FL, 32208-7209, US
Phone (904) 358-8480
Fax (904) 358-8460
Toxanomy
Taxonomy Code 207Q00000X
License State Florida
License Number ME53419
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According to our database, Dr. Willie A Pennick MD NPI is 1568426302, taxonomy code is 207Q00000X and license number is ME53419, license state is located at Florida. Willie A Pennick MD physically located at 1760 Edgewood Ave W, Jacksonville FL, 32208-7209. NPI Number Willie A Pennick MD has the Individual type.

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1568426302 NPI number is provided on an as is basis without warranty of any kind. 1568426302 is maintained by the National Plan & Provider Enumeration System. The contents of Willie A Pennick MD are for informational purposes only.