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Individual

MCKINLEY PETTY III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2555 N DR MARTIN LUTHER KING DR, MILWAUKEE HEALTH SERVICES INC, MILWAUKEE, WI 53212-2709
(414) 372-8080
Mailing address
2555 N DR MARTIN LUTHER KING DR, MILWAUKEE HEALTH SERVICES INC, MILWAUKEE, WI 53212-2709
(414) 372-8080

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21443
WI
208600000X
Surgery Physician
21443
WI
208D00000X
General Practice Physician
21443
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40950100
WI
Enumeration date
09/02/2006
Last updated
09/05/2012
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