Individual
DR. JERI PETTY IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1108 DUPONT CIR, LOUISVILLE, KY 40207-4804
(502) 897-0139
Mailing address
3900 DUPONT SQ S, SUITE B, LOUISVILLE, KY 40207-4615
(502) 584-0128
(502) 584-0149
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
19791
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64197916
—
KY
Enumeration date
04/04/2006
Last updated
10/18/2007
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