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Individual

DR. PATTY K PETTWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
310 WEST BROADWAY STREET, HAVANA, AR 72842-0099
(479) 476-2827
(479) 476-2580
Mailing address
PO BOX 639, DANVILLE, AR 72833-0639
(479) 495-2241
(479) 495-6299

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N8252
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
121717003
AR
Enumeration date
04/07/2006
Last updated
09/18/2015
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