Provider Demographics
NPI:1497982110
Name:PENNA, FRANK JOHN III (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOHN
Last Name:PENNA
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:9 RICHLAND MEDICAL PARK DR STE 500
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6870
Practice Address - Country:US
Practice Address - Phone:803-434-2833
Practice Address - Fax:803-434-2834
Is Sole Proprietor?:No
Enumeration Date:2009-06-20
Last Update Date:2020-06-08
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Provider Licenses
StateLicense IDTaxonomies
MI4301094191208800000X
NH177272088P0231X
SC838122088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
No208800000XAllopathic & Osteopathic PhysiciansUrology