JACK R. PENCE MD NPI 1851399414

NPI Information

NPI: 1851399414
Provider Name: JACK R. PENCE, MD
Classification: Urology - 208800000X
Entity Type: Individual
Address:
1911 N FAIRFIELD RD
SUITE 300
BEAVERCREEK, OH
ZIP 45432
Phone: (937) 429-7352
Get Directions

Jack R. Pence, MD is an urology in Beavercreek, OH. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. Jack R. Pence, MD NPI is 1851399414. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1911 N FAIRFIELD RD
SUITE 300
BEAVERCREEK, OH
ZIP 45432-762
Phone: (937) 429-7352
Fax: (937) 429-3772

The enumeration date for this NPI number is 7/8/2005 and was last updated on 3/17/2014.

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 Code	Taxonomy Clasification	License Number	License State	Primary
1	208800000X	Urology	35-043064	OHIO	No
2	208800000X	Urology	35043064	OHIO	No
3	208800000X	Urology	35043064P	OHIO	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0622857	MEDICAID	OHIO
2	PE0545591	MEDICARE PIN	OHIO
3	C46429	MEDICARE UPIN
4	C46429	MEDICARE UPIN	OHIO

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »