Pennington, Connie Jo

Pennington, Connie Jo is an individual health care provider with primary practice located at 2306 Knob Creek Rd Suite 100, Johnson City TN 37604-2366. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Pennington, Connie Jo can be contacted via phone (423) 610-1177.

Contact Information

Primary practice address
2306 Knob Creek Rd Suite 100 Johnson City TN 37604-2366
Phone: (423) 610-1177
Fax: (423) 610-1179
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD0000030358 Tennessee

Profile Details

NPI number 1790783330
LBN Legal business name Pennington, Connie Jo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Mar 6th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1790783330 NPPES
Tennessee MEDICAID 3875906
Tennessee MEDICAID 3370584

Popular Providers