325 NORTH JEFF DAVIS DR
FAYETTEVILLE, GA 30214 US PECOS Enrolled
Janine Nicole Pettiford
General Surgeon
- FAYETTEVILLE, GA
- Phone: (770)-461-1337
- Last Updated 11/8/2016
Overview
Janine Nicole Pettiford is a General Surgeon in the FAYETTEVILLE area and has over 20 years of experience. Janine Nicole Pettiford primary office location is at 325 NORTH JEFF DAVIS DR and new patients are welcome to contact this healthcare provider for an appointment. She attended Saint Louis University School Of Medicine and graduated 2005
Janine Nicole Pettiford is affiliated with two hospitals in the FAYETTEVILLE area, including NORTHSIDE HOSPITAL. The NPI number is 1043541725 and the information was updated approximately 9 years ago.
Janine Nicole Pettiford is affiliated with one medical group in the FAYETTEVILLE area, NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: YES
Participates in PECOS: YES (See any PECOS details below)
Contact Information
| License Number | State |
|---|---|
| 072414 | GA |
| 2010013505 | MO |
| BP10023659 | TX |
No Identifiers found
| Taxonomy | State | Primary? |
|---|---|---|
| General Surgeon - Taxonomy Code 208600000X | GA | Y |
| General Surgeon - Taxonomy Code 208600000X | MO | N |
| General Surgeon - Taxonomy Code 208600000X | TX | N |
PECOS Details:
| Participates in PECOS: | YES |
| PECOS Individual Enrollment ID: | I20141204002430 |
| PECOS Individual PAC ID: | 7517289374 |
| Eligible to order/refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible to order/refer Durable Medical Equipment (DME) | Yes |
| Eligible to order/refer Home Health Agency (HHA) | Yes |
| Eligible to order/refer Power Mobility Devices (PMD) | Yes |
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