Provider Demographics
NPI:1679684237
Name:DENNY, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:DENNY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4414 LAKE BOONE TRL
Mailing Address - Street 2:SUITE 302
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-7513
Mailing Address - Country:US
Mailing Address - Phone:919-782-8038
Mailing Address - Fax:919-782-8189
Practice Address - Street 1:4414 LAKE BOONE TRL
Practice Address - Street 2:SUITE 302
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7513
Practice Address - Country:US
Practice Address - Phone:919-782-8038
Practice Address - Fax:919-782-8189
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC200300139207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014T8Medicaid
NC891360NMedicaid
NC1360NOtherBCBS INDIVIDUAL
NC562043271OtherTAX ID
NC014T8OtherBCBS GROUP
NC014T8OtherBCBS GROUP
NC1360NOtherBCBS INDIVIDUAL