Individual
MRS. SUE ELLEN PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
320 MICBETH DR, PRINCETON, KY 42445-6332
(270) 365-0320
(270) 365-4150
Mailing address
PO BOX 410, PRINCETON, KY 42445
(270) 365-0320
(270) 365-4150
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34383
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64343833
—
KY
Enumeration date
11/07/2006
Last updated
11/29/2017
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