Individual
CAROLYN K PETTIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9003 E SHEA BLVD, DEPARTMENT OF PATHOLOGY, SCOTTSDALE, AZ 85260-6709
(480) 323-3383
(480) 323-3358
Mailing address
PO BOX 740968, DALLAS, TX 75374-0968
(480) 323-3383
(480) 323-3358
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
20042
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187056
—
AZ
Enumeration date
03/03/2006
Last updated
10/30/2008
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