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
Phone: (336) 716-2255
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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