Provider Demographics
NPI:1013104199
Name:JAMES PETTEY
Entity Type:Organization
Organization Name:JAMES PETTEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PETTEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-650-4094
Mailing Address - Street 1:7720 S BROADWAY
Mailing Address - Street 2:SUITE 530
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2632
Mailing Address - Country:US
Mailing Address - Phone:303-650-4094
Mailing Address - Fax:303-730-0386
Practice Address - Street 1:7720 S BROADWAY
Practice Address - Street 2:SUITE 530
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2632
Practice Address - Country:US
Practice Address - Phone:303-650-4094
Practice Address - Fax:303-730-0386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty