Pettus, Kevin

Pettus, Kevin is an individual health care provider with primary practice located at 7786 Lexington Rd , Lancaster KY 40444-9119. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Legal Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Pettus, Kevin can be contacted via phone (859) 548-4114.

Contact Information

Primary practice address
7786 Lexington Rd Lancaster KY 40444-9119
Phone: (859) 548-4114
Fax: (859) 548-2718
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X 41148 Kentucky
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01056257A Indiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 41148 Kentucky

Profile Details

NPI number 1679641609
LBN Legal business name Pettus, Kevin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Jul 31st, 2009 - about 17 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 1679641609 NPPES
Kentucky Other 000000536447 BCBS-BGC STANFORD PLLC
Kentucky Other 000000536456 BCBS-BGC STANFORD PLLC
Kentucky Other 000000536458 BCBS-BGC STANFORD PLLC

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