Petty, Robert T

Petty, Robert T is an sole proprietor health care provider with primary practice located at 866 Donner Ave , Sonoma CA 95476-7136. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Hospitals / General Acute Care Hospital. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Petty, Robert T can be contacted via phone (360) 708-7940.

Contact Information

Primary practice address
866 Donner Ave Sonoma CA 95476-7136
Phone: (360) 708-7940
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X DO00001542 Washington
Hospitals / General Acute Care Hospital 282N00000X 20A 4256 California
Hospitals / General Acute Care Hospital 282N00000X OP1542 Washington

Profile Details

NPI number 1497795496
LBN Legal business name Petty, Robert T
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 7th, 2006
Last updated Jan 28th, 2013 - about 13 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 1497795496 NPPES
Washington Other 3075PE BSWA
Washington Other 0209144 BSWA
Washington MEDICAID 8214223 BSWA

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