Individual
MR. JOHN G PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2423 E MAIN, STE 4, CORTEZ, CO 81321
(970) 565-8809
(970) 565-8881
Mailing address
2423 E MAIN, STE 4, CORTEZ, CO 81321
(970) 565-8809
(970) 565-8881
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35259
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01352590
—
CO
Enumeration date
02/01/2006
Last updated
10/16/2007
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