Pettis, Shawn James

Pettis, Shawn James is an sole proprietor health care provider with primary practice located at 9015 Arbor St , Omaha NE 68124-2056. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Pettis, Shawn James can be contacted via phone (402) 384-2600.

Contact Information

Primary practice address
9015 Arbor St Omaha NE 68124-2056
Phone: (402) 384-2600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 19105 Nebraska

Profile Details

NPI number 1659421543
LBN Legal business name Pettis, Shawn James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 11th, 2007
Last updated Jul 9th, 2007 - about 19 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 1659421543 NPPES
Nebraska Other 01167 BCBSN
Nebraska Other 2001107 BCBSN
Nebraska MEDICAID 4909390 BCBSN
Nebraska MEDICAID 10025039400 BCBSN
Nebraska Other 6332 BCBSN
Nebraska Other 94522 BCBSN
Nebraska MEDICAID 10024988700 BCBSN
Nebraska MEDICAID 10024988600 BCBSN
Nebraska MEDICAID 10024997200 BCBSN
Nebraska MEDICAID 10024997400 BCBSN
Nebraska Other 2001106 BCBSN
Nebraska Other 2001164 BCBSN

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