Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ETHAN PETTIT, D.O.
Active Sole ProprietorETHAN PETTIT, D.O. is a Pediatrics healthcare provider located in VERNAL, Utah. NPI 1518193184 is currently active in the NPPES registry. Verify at CMS.
Pediatrics · VERNAL, UT
Registration Details
- NPI Number
- 1518193184
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 9, 2009 (17.221412980404 yrs)
- Last Updated
- Feb 6, 2014
- License
-
R-8712 (IA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
175 N 100 WSTE 106VERNAL, UT, 840782049Browse UT providers · Browse ZIP 84078
- Phone
- 4357899060
- Fax
- 4357813048
- Primary Specialty
-
Pediatrics
208000000X
Other Pediatrics Providers in VERNAL, UT
| Name | Credential | NPI |
|---|---|---|
| DR. DANIEL J KWAK | MD | 1023185444 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.