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NPI 1528555067

NPI 1528555067 : JOSHUA CHANDLER PENNIMAN MD : AMARILLO, TX

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General NPI Number Information
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    NPI Number           |    1528555067
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    Entity Type          |    Individual 
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    Provider Name        |    JOSHUA CHANDLER PENNIMAN MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/19/2018
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    Last Update Date     |    08/23/2021
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Provider Practice Location Address
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    Address Line         |    1600 WALLACE BLVD 
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    City                 |    AMARILLO
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    State                |    TX
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    Zip                  |    79106-1799
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    Country              |    US
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    Telephone            |    806-212-2129
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    Fax                  |    806-212-2246
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Provider Business Mailing Address
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    Address Line         |    PO BOX 840026 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75284-0026
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    Country              |    US
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    Telephone            |    806-212-5079
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    Fax                  |    806-212-6278
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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        |    208M00000X
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    Taxonomy Name        |    Hospitalist Physician
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    License Number       |    S8233
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    S8233
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    License Number State |    TX
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