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ROBERT ELDEN PENNINGTON MD PHD PC NPI 1780873547


NPI Information

NPI: 1780873547
Provider Name: ROBERT ELDEN PENNINGTON MD, PHD, PC
Classification: Neuromusculoskeletal Medicine, Sports Medicine - 204C00000X
Entity Type: Organization
Address:
1 EL ARCO IRIS DR
ROSWELL, NM
ZIP 88201
Phone: (505) 625-5512
Get Directions

ROBERT ELDEN PENNINGTON MD, PHD, PC is a neuromusculoskeletal medicine sports medicine in Roswell, NM. The provider is a Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Source: American Osteopathic Association Additional Resources: AOA Osteopathic Board Certification in Neuromusculoskeletal Medicine; https://certification.osteopathic.org/sports-medicine/ ROBERT ELDEN PENNINGTON MD, PHD, PC NPI is 1780873547. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1 EL ARCO IRIS DR
ROSWELL, NM
ZIP 88201-711
Phone: (505) 625-5512
Fax: (505) 625-1013

The provider's authorized official is Robert Pennington .
The authorized official title is Physician Owner and has the following contact phone number (505) 625-5512.

The enumeration date for this NPI number is 10/17/2007 and was last updated on 10/17/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208VP0000XPain MedicinePain Medicine95321NEW MEXICONo
2204C00000XNeuromusculoskeletal Medicine, Sports Medicine95321NEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
172080MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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