Individual
DR. SCOTT D PETHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 BROAD ST, AUGUSTA, GA 30901-1055
(706) 922-5864
(706) 922-5819
Mailing address
1301 BROAD ST, AUGUSTA, GA 30901-1055
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
66307
GA
207RP1001X
Pulmonary Disease Physician
Primary
066307
GA
207RP1001X
Pulmonary Disease Physician
10684R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1492582
—
LA
01
—
4800148
UNITED HEALTHCARE
LA
01
—
5808779
AETNA
LA
Enumeration date
05/16/2006
Last updated
07/31/2025
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