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
Fax: (270) 365-4150
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477622181 NPPES
Kentucky MEDICAID 64343833

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