Marvin Dean Pennington (NPI# 1972534683, PAC ID# 9638078199) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1972534683 |
| PAC ID by PECOS | 9638078199 |
| Professional Enrollment ID | I20040103000028 |
| Full Name | Marvin Dean Pennington |
| Organization Legal Name | AZALEA ORTHOPEDIC AND SPORTS MEDICINE CLINIC PA |
| Address |
3414 Golden Rd Tyler TX 75701-8336 |
| Phone Number | 9039397500 |
| Gender | M |
| Credential | PA |
| Graduation Year | 1998 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 3274524467 |
| Number of Group Practice Members | 40 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450864 | BAYLOR SCOTT & WHITE TEXAS SPINE & JOINT HOSPITAL |
| 450083 | EAST TEXAS MEDICAL CENTER |
| 450389 | EAST TEXAS MEDICAL CENTER ATHENS |
| Address | Phone | Organization |
|---|---|---|
| 708 E Corsicana St, Azalea Orthopedics At Baylor Scott, Athens, TX 75751-2627 | 9039397500 | AZALEA ORTHOPEDIC AND SPORTS MEDICINE CLINIC PA |
| 2211 S Loop, 256 Azalea Orthopedics, Palestine, TX 75801-4701 | 9039397500 | AZALEA ORTHOPEDIC AND SPORTS MEDICINE CLINIC PA |
| 3414 Golden Rd, Tyler, TX 75701-8336 | 9039397500 | AZALEA ORTHOPEDIC AND SPORTS MEDICINE CLINIC PA |
| Organization Legal Name | AZALEA ORTHOPEDIC AND SPORTS MEDICINE CLINIC PA |
| Physicians | 47 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael E Johnson | Orthopedic Surgery | Azalea Orthopedic and Sports Medicine Clinic Pa | 305 W 20th St, Mount Pleasant, TX 75455-2327 |
| Chad J Mcneil | Physical Medicine and Rehabilitation | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Claire Tibiletti | Interventional Pain Management | Azalea Orthopedic and Sports Medicine Clinic Pa | 725 N 4th St, Azalea Orthopedics, Longview, TX 75601-5412 |
| Kim A Foreman | Orthopedic Surgery | Azalea Orthopedic and Sports Medicine Clinic Pa | 725 N 4th St, Azalea Orthopedics, Longview, TX 75601-5412 |
| Drew C Woock | Occupational Therapy | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Jennifer Marie Mckelva | Physician Assistant | Azalea Orthopedic and Sports Medicine Clinic Pa | 305 W 20th St, Mount Pleasant, TX 75455-2327 |
| Corey Lamont Starks | Occupational Therapy | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Jennifer Turner | Nurse Practitioner | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Jerry Wayne Schwarzbach | Physical Medicine and Rehabilitation | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Kevin Wade Luttrell | Orthopedic Surgery | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Street Address |
3414 GOLDEN RD |
| City | TYLER |
| State | TX |
| Zip | 75701-8336 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chad J Mcneil | Physical Medicine and Rehabilitation | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Drew C Woock | Occupational Therapy | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Corey Lamont Starks | Occupational Therapy | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Jennifer Turner | Nurse Practitioner | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Jerry Wayne Schwarzbach | Physical Medicine and Rehabilitation | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Kevin Wade Luttrell | Orthopedic Surgery | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| John Thomas Camp | Hand Surgery | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Robert Wayne Dennis | Orthopedic Surgery | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| James Robert Harris | Orthopedic Surgery | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Ryan William Patterson | Hand Surgery | Azalea Orthopedic and Sports Medicine Clinic Pa | 3414 Golden Rd, Tyler, TX 75701-8336 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jose L Enriquez | Diagnostic Radiology | Tyler Radiology Associates, Pa | 1100 S Beckham, Tyler, TX 75701 |
| Frank P Reuter Jr. | Internal Medicine | 712 S Bois D Arc Ave, Tyler, TX 75701-1503 | |
| Tammy L Michaelsen | Chiropractic | Michaelsen Chiropractic Center, P.C. | 645 S Broadway Ave, Suite 1, Tyler, TX 75701-1676 |
| Mark R Michaelsen | Chiropractic | Michaelsen Chiropractic Center, P.C. | 645 S Broadway Ave, Suite 1, Tyler, TX 75701-1676 |
| James Louis Wasson | Obstetrics/gynecology | 649 S Broadway Ave, Suite 2, Tyler, TX 75701-1677 | |
| Michael C Ford | Ophthalmology | 714 Turtle Creek Dr, Tyler, TX 75701-1833 | |
| Rosalyn L Gooch | Certified Registered Nurse Anesthetist (crna) | Novamed Surgery Center of Tyler, Lp | 802 Turtle Creek Dr, Tyler, TX 75701-1900 |
| Evans S Smith | Emergency Medicine | 833 S Beckham Ave, Tyler, TX 75701-1905 | |
| Li-yu H Mitchell | Family Medicine | 833 S Beckham Ave, Tyler, TX 75701-1905 | |
| Joseph Leonard Decarlo | Urology | Etmc Physician Group, Inc. | 911 S Beckham Ave, Tyler, TX 75701-1907 |
| Find all physicians in zip 75701 | |||
| City | TYLER |
| Zip Code | 75701 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | TYLER + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Marvin Dean Pennington.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.