Individual
DR. BARBARA JEAN PETTITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1364 CLIFTON RD., NE, SURGICAL EDUCATION OFFICE ROOM H-121, ATLANTA, GA 30322
(404) 727-1293
(404) 712-0561
Mailing address
1364 CLIFTON RD., NE, SURGICAL EDUCATION OFFICE ROOM H-121, ATLANTA, GA 30322
(404) 727-1293
(404) 712-0561
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
27629
GA
2086S0120X
Pediatric Surgery Physician
Primary
27629
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27629
GA LICENSE
GA
Enumeration date
11/29/2006
Last updated
12/22/2016
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