Pettle, Theodore G

Pettle, Theodore G is an individual health care provider with primary practice located at 1700 Se Hillmoor Dr , Port St Lucie FL 34952-7539. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Pettle, Theodore G can be contacted via phone (772) 335-9600.

Contact Information

Primary practice address
1700 Se Hillmoor Dr Port St Lucie FL 34952-7539
Phone: (772) 335-9600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X R6457 Texas
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X ME139195 Florida

Profile Details

NPI number 1003102211
LBN Legal business name Pettle, Theodore G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2011
Last updated Sep 14th, 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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