Individual
WILLIAM KIMBALL PETITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
799 E HAMPDEN AVE STE 400, ENGLEWOOD, CO 80113-2766
(303) 789-2663
(303) 788-4871
Mailing address
PO BOX 911244, DENVER, CO 80291-1244
(888) 269-7001
(303) 764-6640
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1599
CO
363AM0700X
Medical Physician Assistant
PA.0001599
CO
363AS0400X
Surgical Physician Assistant
PA.0001599
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000177466
—
CO
Enumeration date
11/03/2005
Last updated
01/09/2024
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