Individual
DR. JEFFREY SCOTT PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3229 W 7TH AVE, CORSICANA, TX 75110-4817
(903) 872-9910
(903) 874-8829
Mailing address
3229 W 7TH AVE, CORSICANA, TX 75110-4817
(903) 872-9910
(903) 874-8829
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018605802
—
TX
01
—
480028382
RAILROAD INS.
TX
01
—
8W4430
BC/BS
TX
01
—
P00339471
RR MCR
—
Enumeration date
07/27/2006
Last updated
07/30/2020
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