Individual
WILLIAM JEFFREY PETTY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10420610
—
VA
01
—
144PR
BCBS
—
01
—
182514
MEDCOST
—
05
—
5905804
—
NC
01
—
7391773
AETNA
—
01
—
809211
PARTNERS
—
05
—
Q0096P
—
SC
Enumeration date
11/29/2005
Last updated
01/10/2008
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