Individual
WILLIAM CHRISTOPHER PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4301 WILSON ST, FORT SILL, OK 73503-4472
(580) 558-2635
(580) 558-2314
Mailing address
4301 WILSON ST, FORT SILL, OK 73503-4472
(580) 558-2635
(580) 558-2314
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
363A00000X
Physician Assistant
Primary
5058
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1158126
NCCPA IDENTIFICATION NUMBER
—
Enumeration date
11/14/2018
Last updated
03/04/2025
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