Pettit, Theron M
Pettit, Theron M is an individual health care provider with primary practice located at 700 Ne 87Th Ave , Vancouver WA 98664-4896. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Pettit, Theron M can be contacted via phone (407) 864-3051.Contact Information
Primary practice address
700 Ne 87Th Ave
Vancouver WA 98664-4896
Phone: (407) 864-3051
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD61603161 | Washington |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | C175441 | California |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME91576 | Florida |
Profile Details
| NPI number | 1245214279 |
|---|---|
| LBN Legal business name | Pettit, Theron M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 2nd, 2005 |
| Last updated | Sep 1st, 2026 - about 2 months 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 | 1245214279 | NPPES |
| Florida | MEDICAID | 272039600 | |
| Florida | Other | 64060 |
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