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Individual
DR. KURT R PETTIPIECE
Active
Individual
DR. KURT R PETTIPIECE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3709AWY
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116973400
—
WY
01
—
3709AWY
WY MEDICAL LICENSE #
WY
01
—
427KP93
WY CONTROLLED SUBSTANCE #
WY
Enumeration date
02/01/2006
Last updated
03/07/2023
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