Laurence M Petty (NPI# 1265655757, PAC ID# 7012818644) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1265655757 |
| PAC ID by PECOS | 7012818644 |
| Professional Enrollment ID | I20040116000631 |
| Full Name | Laurence M Petty |
| Organization Legal Name | FIRST KNIGHT MEDICAL INC |
| Address |
8508 Alafia Hills Dr Plant City FL 33567-3408 |
| Phone Number | 8136508600 |
| Gender | M |
| Credential | MD |
| Medical School | WRIGHT STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1986 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | GERIATRIC MEDICINE, HOSPICE/PALLIATIVE CARE |
| Group Practice PAC ID | 0143201269 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100173 | FLORIDA HOSPITAL TAMPA |
| Address | Phone | Organization |
|---|---|---|
| 8508 Alafia Hills Dr, Plant City, FL 33567-3408 | 8136508600 | FIRST KNIGHT MEDICAL INC |
| Organization Legal Name | FIRST KNIGHT MEDICAL INC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Edward C Reller | Internal Medicine | First Knight Medical Inc | 8508 Alafia Hills Dr, Plant City, FL 33567-3408 |
| Leonne M Reid | Nurse Practitioner | First Knight Medical Inc | 8508 Alafia Hills Dr, Plant City, FL 33567-3408 |
| Ethan Reid | Nurse Practitioner | First Knight Medical Inc | 8508 Alafia Hills Dr, Plant City, FL 33567-3408 |
| Street Address |
8508 ALAFIA HILLS DR |
| City | PLANT CITY |
| State | FL |
| Zip | 33567-3408 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Edward C Reller | Internal Medicine | First Knight Medical Inc | 8508 Alafia Hills Dr, Plant City, FL 33567-3408 |
| Leonne M Reid | Nurse Practitioner | First Knight Medical Inc | 8508 Alafia Hills Dr, Plant City, FL 33567-3408 |
| Ethan Reid | Nurse Practitioner | First Knight Medical Inc | 8508 Alafia Hills Dr, Plant City, FL 33567-3408 |
| City | PLANT CITY |
| Zip Code | 33567 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | PLANT CITY + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Laurence M 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.