Provider Demographics
NPI:1568579720
Name:PENNINGTON, DANIEL W (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:PENNINGTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:621 S ILLINOIS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-5489
Mailing Address - Country:US
Mailing Address - Phone:641-494-3041
Mailing Address - Fax:641-494-3059
Practice Address - Street 1:1000 4TH ST SW
Practice Address - Street 2:SUITE IM
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2800
Practice Address - Country:US
Practice Address - Phone:641-422-6999
Practice Address - Fax:641-422-6678
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2022-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA24241207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA49822OtherWELLMARK
IA12785Medicare ID - Type Unspecified
IA49822OtherWELLMARK
IA0194118Medicare ID - Type Unspecified