1164550562 NPI number — PENNEY C STRINGER

Table of content: PENNEY C STRINGER (NPI 1164550562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164550562 NPI number — PENNEY C STRINGER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRINGER
Provider First Name:
PENNEY
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STRINGER
Provider Other First Name:
PENNEY
Provider Other Middle Name:
C
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1164550562
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
750 GEORGE WASHINGTON WAY
Provider Second Line Business Mailing Address:
SUITE 5
Provider Business Mailing Address City Name:
RICHLAND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99352-4247
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-943-1122
Provider Business Mailing Address Fax Number:
509-943-1125

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
750 GEORGE WASHINGTON WAY
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
RICHLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99352-4247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-943-1122
Provider Business Practice Location Address Fax Number:
509-943-1125
Provider Enumeration Date:
02/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD00038209 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MD00038209 . This is a "LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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