NPI 1003270422

Michael Petry

Practitioner Family Medicine Physician Crestwood, KY

Practice location

Address: 6411 Veterans Memorial Pkwy, Crestwood, KY 40014-8698
Phone: (502) 241-8611
Fax: (502) 241-4175
Mailing address: PO Box 776351, Chicago, IL 60677-6351

Registered specialties (2)

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence R4220 (KY)

Other Family Medicine providers in Kentucky →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1003270422
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Apr 2016
Record last updated: 8 Dec 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.