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Contact Information

GREGORY D PENNOCK, MD
423 N THIRD AVE STE 335
SANDPOINT, ID83864
 Phone: 208-265-7070
 Fax: 208-265-7071
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for GREGORY D PENNOCK · (Male)

NPI # 1700889607
Status Active
Credentials MD
Entity Individual
Enumeration date 05/24/2005
Last updated 06/08/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • ID License # M12621
Hospital affiliation(s)
  • PORTNEUF MEDICAL CENTER - (Acute Care)
    777 HOSPITAL WAY
    POCATELLO, ID 83201
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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