Petty, Sue Ellen
Petty, Sue Ellen is an individual health care provider with primary practice located at 320 Micbeth Dr , Princeton KY 42445-6332. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Petty, Sue Ellen can be contacted via phone (270) 365-0320.Contact Information
Primary practice address
320 Micbeth Dr
Princeton KY 42445-6332
Phone: (270) 365-0320
Fax: (270) 365-4150
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 34383 | Kentucky |
Profile Details
| NPI number | 1477622181 |
|---|---|
| LBN Legal business name | Petty, Sue Ellen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Nov 29th, 2017 - about 9 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 | 1477622181 | NPPES |
| Kentucky | MEDICAID | 64343833 |
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