Penta, John R
Penta, John R is an sole proprietor health care provider with primary practice located at 950 Breckenridge Ln Ste 200 , Louisville KY 40207-5929. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Penta, John R can be contacted via phone (502) 893-6777.Contact Information
Primary practice address
950 Breckenridge Ln Ste 200
Louisville KY 40207-5929
Phone: (502) 893-6777
Fax: (502) 899-5535
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 21548 | Kentucky |
Profile Details
| NPI number | 1760484604 |
|---|---|
| LBN Legal business name | Penta, John R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 11th, 2005 |
| Last updated | Dec 7th, 2020 - about 4 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 | 1760484604 | NPPES |
| Other | 000000247085 | ANTHEM | |
| Other | 50000082 | ANTHEM | |
| Other | P01026547 | ANTHEM | |
| MEDICAID | 64215486 | ANTHEM |
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