Individual
DR. WAYMOND JAY PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3620 S TAYLOR RD, DECATUR, IL 62521-9015
(217) 454-0022
Mailing address
451 E 1000 N, LA PORTE, IN 46350-8638
(219) 778-8524
(219) 778-8534
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036051290
IL
Other
Enumeration date
08/20/2008
Last updated
08/20/2008
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