Healthcare Provider Details

I. General information

NPI: 1801015136
Provider Name (Legal Business Name): SHARON MARIE PENNINGTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARON MARIE MCDONALD M.D.

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 LIBERTY RD
FLOWOOD MS
39232-9000
US

IV. Provider business mailing address

803 LIBERTY RD
FLOWOOD MS
39232-9000
US

V. Phone/Fax

Practice location:
  • Phone: 601-714-1967
  • Fax: 601-714-1966
Mailing address:
  • Phone: 601-714-1967
  • Fax: 601-714-1966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number21221
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: