Pettway, Laquetta Nicol
Pettway, Laquetta Nicol is an sole proprietor health care provider with primary practice located at 1360 Montgomery Hwy Suite 114, Vestavia AL 35216-2749. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Pettway, Laquetta Nicol can be contacted via phone (205) 978-7550.Contact Information
Primary practice address
1360 Montgomery Hwy Suite 114
Vestavia AL 35216-2749
Phone: (205) 978-7550
Fax: (205) 978-7551
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD.19390 | Alabama |
Profile Details
| NPI number | 1376588095 |
|---|---|
| LBN Legal business name | Pettway, Laquetta Nicol |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 17th, 2006 |
| Last updated | Sep 22nd, 2021 - about 5 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 | 1376588095 | NPPES |
| Alabama | Other | 051119644 | BCBS |
| Alabama | Other | 1376588095 | BCBS |
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