Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. IAN JOSEPH PENNISTON, D.O.
ActiveDR. IAN JOSEPH PENNISTON, D.O. is a 2084B0040X healthcare provider located in NORTH LAS VEGAS, Nevada. NPI 1023451101 is currently active in the NPPES registry. Verify at CMS.
2084B0040X · NORTH LAS VEGAS, NV
Registration Details
- NPI Number
- 1023451101
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 9, 2013 (13.333125156109 yrs)
- Last Updated
- Jun 30, 2023
- Licenses
-
59778 (MN)59778 (MN)59778 (MN)59778 (MN)
Practice Information
- Address
-
6900 N PECOS RDNORTH LAS VEGAS, NV, 890864400Browse NV providers · Browse ZIP 89086
- Phone
- 7027919000
- Primary Specialty
-
2084B0040X
2084B0040X
- Additional Specialty
- Psychiatry
- Additional Specialty
- Vascular Surgery
- Additional Specialty
- 2084B0040X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.