Corwin D. Petty, Md, Pa

LBN: Corwin D. Petty, Md, Pa
Corwin D. Petty, Md, Pa is an health care organization with primary practice located at 3201 S Market St Ste 105 , Rogers AR 72758-8168. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Corwin D. Petty, Md, Pa can be contacted via phone (479) 254-1005, or through Petty, Corwin D via phone (479) 254-1005.

Contact Information

Primary practice address
3201 S Market St Ste 105 Rogers AR 72758-8168
Phone: (479) 254-1005
Fax: (479) 668-4003
Website:
Map and Directions
Authorized official contact:
Name: Petty, Corwin D Doctor of Medicine (MD)
Phone: (479) 254-1005

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1881859593
LBN Legal business name Corwin D. Petty, Md, Pa
DBA Doing business as
Authorized official Petty, Corwin D Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 22nd, 2008
Last updated Apr 4th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881859593 NPPES
Arkansas Other 5C680 BLUE CROSS BLUE SHIELD
Arkansas MEDICAID 149427002 BLUE CROSS BLUE SHIELD

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