Fred Petty (NPI# 1841291333, PAC ID# 3375517303) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIOVASCULAR DISEASE (CARDIOLOGY).
| Nation Provider ID (NPI) | 1841291333 |
| PAC ID by PECOS | 3375517303 |
| Professional Enrollment ID | I20040824001334 |
| Full Name | Fred Petty |
| Organization Legal Name | FIELD MEMORIAL COMMUNITY HOSPITAL |
| Address |
178 Hwy 24 E B Field Specialty Clinic Centreville MS 39631-4171 |
| Phone Number | 6016455221 |
| Gender | M |
| Credential | MD |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT |
| Graduation Year | 1988 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 0547248544 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190064 | OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER |
| 190065 | BATON ROUGE GENERAL MEDICAL CENTER |
| 251309 | FIELD HEALTH SYSTEM |
| 190020 | LANE REGIONAL MEDICAL CENTER |
| 191309 | HOOD MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 5131 Odonovan Dr, Baton Rouge, LA 70808-4791 | 2253740110 | LSUHN BILLING LLC |
| 5231 Brittany Dr, Baton Rouge, LA 70808-9143 | 2257690933 | BATON ROUGE CARDIOLOGY CENTER |
| 178 Hwy 24 E, Centreville, MS 39631-4171 | FIELD MEMORIAL COMMUNITY HOSPITAL | |
| 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 | 6016455221 | FIELD MEMORIAL COMMUNITY HOSPITAL |
| 178 Hwy 24 E B, Centreville, MS 39631-4171 | 6016455221 | FIELD MEMORIAL COMMUNITY HOSPITAL |
| 1410 Main E St, Fmch Liberty Clinic, Liberty, MS 39645-0514 | 6018883421 | FIELD MEMORIAL COMMUNITY HOSPITAL |
| 1410 Main E St, Liberty, MS 39645-0514 | 6018883421 | FIELD MEMORIAL COMMUNITY HOSPITAL |
| Organization Legal Name | FIELD MEMORIAL COMMUNITY HOSPITAL |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ndeke Nyirenda | Family Medicine | Field Memorial Community Hospital | 178 Hwy 24 E, Centreville, MS 39631-4171 |
| Pradeep Kumar Selvaraj | Internal Medicine | Field Memorial Community Hospital | 451 Bank St, Woodville, MS 39664-0876 |
| James Caulfield Leak | Family Medicine | Field Memorial Community Hospital | 434 N Captain Dr, Gloster, MS 39638 |
| Trinity J Mckenzie | Family Medicine | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Robert L Lewis | Internal Medicine | Field Memorial Community Hospital | 451 Bank St, Woodville, MS 39664-0876 |
| James Lee Hawley | Nurse Practitioner | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| David Burnell Mcgraw | Family Medicine | Field Memorial Community Hospital | 451 Bank St, Woodville, MS 39664-0876 |
| Ricardo A Nimo | Internal Medicine | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Harold G Clausen | Cardiovascular Disease (cardiology) | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Richard J Field Iii | General Surgery | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Street Address |
178 HWY 24 E B FIELD SPECIALTY CLINIC |
| City | CENTREVILLE |
| State | MS |
| Zip | 39631-4171 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Trinity J Mckenzie | Family Medicine | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| James Lee Hawley | Nurse Practitioner | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Ricardo A Nimo | Internal Medicine | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Harold G Clausen | Cardiovascular Disease (cardiology) | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Richard J Field Iii | General Surgery | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Alicia F Randall | Clinical Social Worker | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Thomas E Wills | Urology | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Simmons T Copeland | Nurse Practitioner | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Kimberly Diane Gabriel | Family Medicine | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Jennifer W Lanehart | Nurse Practitioner | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ndeke Nyirenda | Family Medicine | Field Memorial Community Hospital | 178 Hwy 24 E, Centreville, MS 39631-4171 |
| Kathleen R Huff | Physician Assistant | Field Memorial Community Hospital | 178 Hwy 24 E B, Field Specialty Clinic, Centreville, MS 39631-4171 |
| City | CENTREVILLE |
| Zip Code | 39631 |
| Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| City + Specialty | CENTREVILLE + CARDIOVASCULAR DISEASE (CARDIOLOGY) |
Please comment or provide details below to improve the information on Fred Petty.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.