IndividualActive
Benjamin Pennock
NPI 1720874555 · Psychiatry Physician · Boise, ID
Provider details
- NPI number
- 1720874555
- Entity type
- Individual
- Primary specialty
- Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Student, Health Care
Practice location
500 W Fort St
Boise, ID 83702-4501
Phone: (208) 422-1000
Approximate (ZIP-level) locationGet directions
Mailing address
500 W Fort St
Boise, ID 83702-4501
Registry dates
- Enumerated
- 2025-04-17
- Last updated
- 2025-05-15
- Certified
- 2025-05-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.