NPI 1457312308

Wendell E Petty, MD

Practitioner Allergy & Immunology Physician Idaho Falls, ID

Practice location

Address: 3422 S 15th E, Idaho Falls, ID 83404-8262
Phone: (208) 529-9292
Fax: (208) 525-6013

Registered specialties

Allergy & Immunology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207K00000X Licence MD-2580 (ID)

Other Allergy & Immunology providers in Idaho →

Registry record

NPI: 1457312308
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Mar 2006
Record last updated: 21 Jun 2019

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.