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Individual
DR. JEFFREY SCOTT PETTY
Active
Individual
DR. JEFFREY SCOTT PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018605802
—
TX
01
—
480028382
RAILROAD INS.
TX
01
—
8W4430
BC/BS
TX
01
—
P00339471
RR MCR
—
Enumeration date
07/27/2006
Last updated
07/30/2020
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