Individual provider · Type 1 NPI

Keith Pettibon, MD

Diagnostic Radiology Physician · Fort Worth, TX

NPI number 1467744573 Active

Practice location

815 Pennsylvania Ave
Fort Worth, TX 76104

Call (817) 321-0404 Map

Mailing address

816 W Cannon St
Fort Worth, TX 76104-3146

Specialties and licenses

TaxonomyCodeLicense
Vascular & Interventional Radiology Physician 2085R0204XR1614 (TX)
Diagnostic Radiology Physician Primary 2085R0202XR1614 (TX)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1467744573

Keith Pettibon, MD's National Provider Identifier is 1467744573, issued on May 7, 2011. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Fort Worth, TX. The record was last updated on Jun 13, 2024.