John K Petty
Surgeon Pediatric Surgery Surgical Critical Care
Medical Center Blvd
Winston Salem
, North Carolina 27157-0001
John K Petty
Surgeon Pediatric Surgery Surgical Critical Care
Medical Center Blvd
Winston Salem
, North Carolina 27157-0001
(336) 716-6637
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About
Features
Specialties
- Surgeon
- Surgical Critical Care
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- John K Petty
- Po Box 344
- Winston Salem, NC
- Zip : 27102-0344
- Fax : (336) 716-6637
- Phone : (336) 716-2255
Second Address
- John K Petty
- Medical Center Blvd
- Winston Salem, NC
- Zip : 27157-0001
- Fax : (336) 716-6637
- Phone : (336) 716-2255
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FAQs
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Is John K Petty a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208200000X | Surgeon | 200501628 | NC |
| Y | 208600000X | Surgeon | 200501628 | NC |
| N | 2086S0102X | Surgical Critical Care | 200501628 | NC |
| N | 2086S0120X | Pediatric Surgery | 200501628 | NC |
National Provider Identifier
| NPI | 1497731095 |
|---|---|
| Provider Name | John K Petty |
| First Address | Winston Salem, NC 27102-0344 |
| Second Address | Winston Salem, NC 27157-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/12/2005 |
| Last Update Date | 12/11/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 10211484 | (05) | VA |
| 14042 | BCBS (01) | |
| 184276 | MEDCOST (01) | |
| 3810003638 | (05) | WV |
| 5902325 | (05) | NC |
| 7290767 | AETNA (01) | |
| 806729 | PARTNERS (01) | |
| I44855 | (02) | |
| Q01623 | (05) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.