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Contact Information

HENRY D PETRY, DO
931 E 32ND ST
JOPLIN, MO64804-2808
 Phone: 417-347-4374
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for HENRY D PETRY · (Male)

NPI Number 1770568164
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 12/08/2005
Last updated 08/31/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 31192
  • MO Medicaid 240027425
Hospital affiliation(s)
  • FREEMAN HEALTH SYSTEM - FREEMAN WEST - (Acute Care)
    1102 WEST 32ND STREET
    JOPLIN, MO 64804
  • MERCY HOSPITAL JOPLIN - (Acute Care)
    2817 ST JOHNS BLVD
    JOPLIN, MO 64804
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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