MEDICARE: DR. DONALD W. 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
1	207X00000X	Orthopaedic Surgery Physician	DO3274	NV

General Provider Information

NPI Number	:	1538112792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD W. PENNINGTON D.O.

Provider Business Mailing Address
First Line	:	9499 W CHARLESTON BLVD STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7147
Country	:	US
Telephone Number	:	702-933-9393
Fax Number	:	702-933-6789

Provider Business Practice Location Address
First Line	:	9499 W CHARLESTON BLVD STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7147
Country	:	US
Telephone Number	:	29-339-3937
Fax Number	:	702-933-6789

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	09/16/2025

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