Petrocelli, Joseph C

Petrocelli, Joseph C is an individual health care provider with primary practice located at 910 Wallace Ave , Leitchfield KY 42754-2414. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Petrocelli, Joseph C can be contacted via phone (270) 259-3035.

Contact Information

Primary practice address
910 Wallace Ave Leitchfield KY 42754-2414
Phone: (270) 259-3035
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 20679 Kentucky

Profile Details

NPI number 1538162268
LBN Legal business name Petrocelli, Joseph C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Feb 1st, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538162268 NPPES
Kentucky Other 2433736000 PASSPORT ADVANTAGE
Kentucky Other 611269278001 PASSPORT ADVANTAGE
Kentucky Other 1054879 PASSPORT ADVANTAGE
Kentucky Other 000000050793 PASSPORT ADVANTAGE
Kentucky MEDICAID 64206790 PASSPORT ADVANTAGE

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