Petty, Gary J
Petty, Gary J is an sole proprietor health care provider with primary practice located at 659 Central Ave , Barboursville WV 25504. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Petty, Gary J can be contacted via phone (304) 736-5247.Contact Information
Primary practice address
659 Central Ave
Barboursville WV 25504
Phone: (304) 736-5247
Fax: (304) 736-7367
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35-07-5727 | Ohio |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036118847 | Illinois |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 50755020 | Wisconsin |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 17521 | West Virginia |
Profile Details
| NPI number | 1942279013 |
|---|---|
| LBN Legal business name | Petty, Gary J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Jan 14th, 2022 - about 2 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 | 1942279013 | NPPES |
| Ohio | MEDICAID | 1804764000 | |
| Ohio | Other | 000000699790 | |
| Ohio | Other | P00693880 | |
| Ohio | Other | 000000593893 | |
| Ohio | MEDICAID | 2255250 |
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