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MR. CHARLES ROYCE PENNINGTON M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1669589594

Individual Registrant:
MR. CHARLES ROYCE PENNINGTON M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
92 BETTYS CREEK RD  DILLARD, GA 30537-2257 US
Tel: 706-746-6571  Fax: 706-746-5643

Contact information for business:
PO BOX 444  DILLARD, GA 30537-0444 US
Tel: 706-746-6571  Fax: 706-746-5643

Registration Information:
NPI: 1669589594
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
GA025380

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
000649822AGA05
000273831GGA05




HEALTH CARE JOBS GA - Page 1



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