Benjamin Walker Pennock
Benjamin Walker Pennock is a Student in an Organized Health Care Education/Training Program in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2025.
- Licensed in
- ID
- In the registry since
- 2025
- Specialties on file
- 2
Practice location Address checks out
500 W Fort StBoise, ID 83702-4501
Phone: (208) 422-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatry Physician (primary) | Taxonomy 2084P0800X · Licence 3071063 (ID) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1720874555 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | April 17, 2025 |
| Last updated in NPPES | May 15, 2025 |
| Certification date | May 15, 2025 |
| Mailing address | 500 W Fort St, Boise, ID 83702-4501 |
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