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NPI Code Detail

MEDICARE: DR. SCOTT DAVID PENNINGTON D.O.

MEDICARE: DR. SCOTT DAVID PENNINGTON D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician70115CT
2207L00000XAnesthesiology Physician95543GA

General Provider Information

NPI Number : 1154391613
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT DAVID PENNINGTON D.O.
Provider Business Mailing Address
First Line : 2540 WINDY HILL RD SE
Second Line :
City : MARIETTA
State : GA
Zip : 30067-8605
Country : US
Telephone Number : 470-644-1274
Fax Number :
Provider Business Practice Location Address
First Line : 2540 WINDY HILL RD SE
Second Line :
City : MARIETTA
State : GA
Zip : 30067-8605
Country : US
Telephone Number : 470-644-1274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 07/12/2023

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Directions to “ DR. SCOTT DAVID PENNINGTON D.O.” Practice Location

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