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Contact Information

KEVIN PETTUS, MD
7786 LEXINGTON RD
LANCASTER, KY40444-9119
 Phone: 859-548-4114
 Fax: 859-548-2718
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Legal Medicine

173000000X
Indicates primary specialty

NPI Profile & details for KEVIN PETTUS · (Male)

NPI Number 1679641609
Status Active
Credentials MD
Entity Individual
Enumeration date 11/30/2006
Last updated 07/31/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01056257A
  • KY License # 41148
  • KY Other 000000536458 BCBS-BGC LIBERTY, PLLC
  • KY Other 000000536447 BCBS-BGC STANFORD PLLC
  • KY Other 000000536456 BCBS-STANFORD FAMILY MED
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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