Petty, William Jeffrey

Petty, William Jeffrey is an individual health care provider with primary practice located at Medical Center Blvd , Winston Salem NC 27157-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Petty, William Jeffrey can be contacted via phone (336) 716-2255.

Contact Information

Primary practice address
Medical Center Blvd Winston Salem NC 27157-0001
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X North Carolina

Profile Details

NPI number 1164406690
LBN Legal business name Petty, William Jeffrey
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2005
Last updated Jan 10th, 2008 - about 17 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 1164406690 NPPES
Other 144PR BCBS
Other 7391773 BCBS
MEDICAID Q0096P BCBS
MEDICAID 10420610 BCBS
Other 182514 BCBS
MEDICAID 5905804 BCBS
Other 809211 BCBS

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