Organization
JEFFREY PETTY, DPM, PA
Active
Other names
Corsicana Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY SCOTT PETTY DPM (OWNER)
(903) 872-9910
Entity
Organization
Contact information
Practice address
3229 W 7TH AVE, CORSICANA, TX 75110-4817
(903) 872-9910
(903) 874-8829
Mailing address
PO BOX 1774, CORSICANA, TX 75151-1774
(903) 872-9910
(903) 874-8829
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018605801
—
TX
05
—
183236201
—
TX
01
—
DF1159
RAILROAD MCR
—
Enumeration date
07/27/2006
Last updated
07/21/2015
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