Pettit, Kenneth Lee

Pettit, Kenneth Lee is an individual health care provider with primary practice located at 40 S Kyrene Rd Suite 1, Chandler AZ 85226-4675. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Pettit, Kenneth Lee can be contacted via phone (480) 706-0174.

Contact Information

Primary practice address
40 S Kyrene Rd Suite 1 Chandler AZ 85226-4675
Phone: (480) 706-0174
Fax: (480) 706-0117
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3144 Arizona
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E07166 Hawaii
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 2083P0011X 3144 Arizona

Profile Details

NPI number 1447296298
LBN Legal business name Pettit, Kenneth Lee
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Sep 9th, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447296298 NPPES
Arizona MEDICAID 437609

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