Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. GREGORY D PENNOCK, MD
DeactivatedCardiovascular Disease · SANDPOINT, ID
This NPI has been deactivated.
The record was deactivated on March 16, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1700889607
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 24, 2005 (0.81095890410959 yrs)
- Last Updated
- Jun 8, 2018
- Deactivated
- Mar 16, 2006
- License
-
M12621 (ID)
Practice Information
- Address
-
423 N THIRD AVE STE 335SANDPOINT, ID, 83864Browse ID providers · Browse ZIP 83864
- Phone
- 2082657070
- Fax
- 2082657071
- Primary Specialty
-
Cardiovascular Disease
207RC0000X
Other Cardiovascular Disease Providers in SANDPOINT, ID
| Name | Credential | NPI |
|---|---|---|
| DR. RUSSELL R BLAKELEY | M.D. | 1063409639 |
| LAWRENCE DERBES JR. | MD | 1902906787 |
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.