DR. PAUL M PETTY (NPI# 1932391091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932391091 |
| Entity Type | Individual |
| Full Name | DR. PAUL M PETTY |
| Credential | M.D. |
| Practice Address |
1225 N State St Jackson MS 39202-2064 |
| Mailing Address |
4344 Audubon Park Ln Jackson MS 39211-6142 |
| Practice Telephone | 3182869787 |
| Mailing Telephone | 3182869787 |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2012-02-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 21160 | MS | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | N/A | LA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396192126 | Paul Aaron Petty | Specialist | 1715 N George Mason Dr Ste 503, Arlington, VA 22205-3669 | 2016-05-23 |
| 1730363003 | Paul Ceif Petty | Chiropractor | 1530 Baker St Ste G, Costa Mesa, CA 92626-3752 | 2007-12-21 |
| 1629058086 | Paul M Petty | Plastic Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2006-01-20 |
| Street Address |
1225 N STATE ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-2064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013919216 | Richard B Friedman | Radiology | 1225 N State St, Jackson, MS 39202-2064 | 2005-06-01 |
| 1326649336 | Sharron Rena Brown | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2097 | 2020-11-05 |
| 1861009714 | April Stevenson Corcoran | Registered Nurse | 1225 N State St, Jackson, MS 39202-2064 | 2020-09-24 |
| 1609485440 | Mississippi Baptist Medical Center, Inc. | Clinical Medical Laboratory | 1225 N State St, Jackson, MS 39202-2064 | 2020-07-28 |
| 1912530569 | Brandi Burge Wagner | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2064 | 2020-02-21 |
| 1760028955 | Erin Jones | Registered Nurse | 1225 N State St, Jackson, MS 39202-2064 | 2019-11-21 |
| 1780229641 | Lauren Blakeney | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2064 | 2019-11-14 |
| 1417591322 | Lou Ann Wells | Registered Nurse | 1225 N State St, Jackson, MS 39202-2064 | 2019-11-04 |
| 1861043531 | Jessica Candace Cody | Anesthesiology | 1225 N State St, Jackson, MS 39202-2064 | 2019-09-24 |
| 1386290955 | Brady K Lowery | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2064 | 2019-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891141032 | Tobin S Dennis | Emergency Medicine | 625 East Broadway Ave, Jackson, WY 83001-8642 | 2016-05-06 |
| 1902270093 | Steven Pirtle French | Emergency Medicine | 6605 N Snake River Woods Dr, Jackson, WY 83001-8491 | 2015-11-30 |
| 1942612015 | Emergency Associates Pllc | Emergency Medicine | 2660 Ridgewood Rd, Suite 100, Jackson, MS 39216-4921 | 2014-05-23 |
| 1083995674 | Obhg Mississippi, P.C. | Emergency Medicine | 1225 N State St Ste B1, Jackson, MS 39202-2072 | 2011-09-09 |
| 1508180183 | Jon Edward Zamber | Emergency Medicine | 361 Willie Adams Rd, Jackson, TN 38305-7223 | 2010-03-25 |
| 1750510962 | Jason Robert Schwanebeck | Emergency Medicine | University of Missisippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505 | 2009-07-09 |
| 1366629214 | Joseph Scott Savage | Emergency Medicine | 400 N Alpine Lake Dr, Suite F, Jackson, MI 49203-6334 | 2008-01-23 |
| 1689709610 | Dawn Nicole Laws | Emergency Medicine | 1325 N West Ave, Jackson, MI 49202-2050 | 2007-02-22 |
| 1194834747 | Joseph W Blackston | Emergency Medicine | 1900 Petit Bois St N, Jackson, MS 39211-6707 | 2006-08-29 |
| 1174637318 | Kaushal Patel | Emergency Medicine | 205 Trace Dr, Jackson, TN 38305-1580 | 2006-08-17 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.