Pethke, Scott D
Pethke, Scott D is an individual health care provider with primary practice located at 1301 Broad St , Augusta GA 30901-1055. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Pethke, Scott D can be contacted via phone (706) 922-5864.Contact Information
Primary practice address
1301 Broad St
Augusta GA 30901-1055
Phone: (706) 922-5864
Fax: (706) 922-5819
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 066307 | Georgia |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 10684R | Louisiana |
Profile Details
| NPI number | 1609828094 |
|---|---|
| LBN Legal business name | Pethke, Scott D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2006 |
| Last updated | Nov 18th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609828094 | NPPES |
| Louisiana | Other | 5808779 | AETNA |
| Louisiana | MEDICAID | 1492582 | AETNA |
| Louisiana | Other | 4800148 | AETNA |
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