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Contact Information

JOHN G PETTY, MD
2423 E MAIN
STE 4
CORTEZ, CO81321
 Phone: 970-565-8809
 Fax: 970-565-8881
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for JOHN G PETTY · (Male)

NPI # 1881665263
Status Active
Credentials MD
Entity Individual
Enumeration date 02/01/2006
Last updated 10/16/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • CO License # 35259
  • CO Medicaid 01352590
Hospital affiliation(s)
  • SOUTHWEST MEMORIAL HOSPITAL - (Critical Access)
    1311 N MILDRED RD
    CORTEZ, CO 81321
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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