| Doctor Name: | MR. MICHAEL L PENDLETON |
| NPI Number: | 1053640698 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP |
| License Number: | 6291P |
| Business Practice Address: | 100 Reynolds Rd Suite A Glasgow, KY - 421411177 |
| Business Phone Number: | 2706786333 |
| Business Fax Number: | 2706787333 |
| Mailing Address: | Po Box 906, GLASGOW |
| State: | KY |
| Postal Code: | 421420906 |
| Phone Number: | 2706786333 |
| Fax Number: | 2706787333 |
| NPI Enumeration Date: | 12/10/2009 |
| NPI Last Update Date: | 08/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 6291P |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |