Pettus, Kevin
Pettus, Kevin is an individual health care provider with primary practice located at 7786 Lexington Rd , Lancaster KY 40444-9119. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Legal Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Pettus, Kevin can be contacted via phone (859) 548-4114.Contact Information
Primary practice address
7786 Lexington Rd
Lancaster KY 40444-9119
Phone: (859) 548-4114
Fax: (859) 548-2718
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Legal Medicine | 173000000X | 41148 | Kentucky |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01056257A | Indiana |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 41148 | Kentucky |
Profile Details
NPI number | 1679641609 |
---|---|
LBN Legal business name | Pettus, Kevin |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 30th, 2006 |
Last updated | Jul 31st, 2009 - about 15 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 | 1679641609 | NPPES |
Kentucky | Other | 000000536447 | BCBS-BGC STANFORD PLLC |
Kentucky | Other | 000000536456 | BCBS-BGC STANFORD PLLC |
Kentucky | Other | 000000536458 | BCBS-BGC STANFORD PLLC |
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