Provider Demographics
NPI:1053638700
Name:PENDLETON, JOHN MORRELL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MORRELL
Last Name:PENDLETON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1700 RING RD
Mailing Address - Street 2:HARDIN MEMORIAL SURGICAL SPECIALISTS
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-9497
Mailing Address - Country:US
Mailing Address - Phone:270-769-5551
Mailing Address - Fax:
Practice Address - Street 1:1700 RING RD
Practice Address - Street 2:HARDIN MEMORIAL SURGICAL SPECIALISTS
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-9497
Practice Address - Country:US
Practice Address - Phone:270-769-5551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY48925208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery