Provider Demographics
NPI:1649245432
Name:PENSON, SONJA ANISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:SONJA
Middle Name:ANISSA
Last Name:PENSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-364-7070
Mailing Address - Fax:
Practice Address - Street 1:2400 MT. ZION PARKWAY KAISER PERMANENTE
Practice Address - Street 2:SOUTHWOOD COMPREHENSIVE MEDICAL CENTER
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236
Practice Address - Country:US
Practice Address - Phone:770-603-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2022-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA048562207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine