Pennington, Crystal Rose
Pennington, Crystal Rose is an individual health care provider with primary practice located at 7301 Rogers Ave Box 1426, Fort Smith AR 72903-4100. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Pennington, Crystal Rose can be contacted via phone (479) 441-5215.Contact Information
Primary practice address
7301 Rogers Ave Box 1426
Fort Smith AR 72903-4100
Phone: (479) 441-5215
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | E-7102 | Arkansas |
Profile Details
| NPI number | 1811103542 |
|---|---|
| LBN Legal business name | Pennington, Crystal Rose |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2007 |
| Last updated | Feb 21st, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811103542 | NPPES |
| Arkansas | MEDICAID | 193382001 | |
| Arkansas | MEDICAID | 200441210A |
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