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

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NPI Details

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 Taxonomy Specialization License Number License State Primary
1208800000XUrology35-043064OHIONo
2208800000XUrology35043064OHIONo
3208800000XUrology35043064POHIOYes

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 Other Provider Identifier Issuer
10622857MEDICAIDOHIO
2PE0545591MEDICARE PINOHIO
3C46429MEDICARE UPIN
4C46429MEDICARE UPINOHIO

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: 11/21/2025

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