Provider Demographics
NPI:1700808169
Name:PENNINGTON, JAMES HENRY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HENRY
Last Name:PENNINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5147 N 9TH AVE
Mailing Address - Street 2:SUITE 325A
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8771
Mailing Address - Country:US
Mailing Address - Phone:850-475-9025
Mailing Address - Fax:850-494-7855
Practice Address - Street 1:5147 N 9TH AVE
Practice Address - Street 2:SUITE 325A
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8771
Practice Address - Country:US
Practice Address - Phone:850-475-9025
Practice Address - Fax:850-494-7855
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53420207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE49305Medicare UPIN
FL07668Medicare ID - Type Unspecified