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General NPI Number Information
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NPI Number | 1063402519
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Entity Type | Individual
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Provider Name | STEPHEN PATRICK PENOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 3633 CENTRAL AVENUE SUITE D
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City | HOT SPRINGS
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State | AR
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Zip | 71913-6475
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Country | US
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Telephone | 501-623-6693
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Fax | 501-623-9403
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Provider Business Mailing Address
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Address Line | 3633 CENTRAL AVENUE SUITE D
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City | HOT SPRINGS
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State | AR
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Zip | 71913-6475
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Country | US
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Telephone | 501-623-6693
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Fax | 501-623-9403
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | E3410
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | E-3410
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | V7274
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | E-3410
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License Number State | AR
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