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Keith Pettibon, MD
Diagnostic Radiology Physician in Fort Worth, Texas
NPI 1467744573

Keith Pettibon is a Diagnostic Radiology Physician based in Fort Worth, TX and is specialized in Diagnostic Radiology. Keith Pettibon practices in Fort Worth, TX and has the professional credentials of MD. The NPI Number for Keith Pettibon is 1467744573 and holds a License No. R1614 (Texas).

The current practice location address for Keith Pettibon is 815 Pennsylvania Ave, Fort Worth, TX and can be reached out via phone at 817-321-0404.

Location: 815 Pennsylvania Ave, Fort Worth, TX, 76104-3146
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467744573
Provider Name
Keith Pettibon
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
815 Pennsylvania Ave, Fort Worth, TX, 76104-3146
Phone Number
817-321-0404
Fax Number
Provider Enumeration Date
05/07/2011
Last Update Date
07/20/2024
institution
Provider Business Practice Location Address Details
Address
815 Pennsylvania Ave
City
Fort Worth
State
Texas
Zip
76104
Phone Number
817-321-0404
Fax Number
person
Provider Business Mailing Address Details
Address
815 Pennsylvania Ave
City
Fort Worth
State
Texas
Zip
76104
Phone Number
817-321-0404
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
R1614 (Texas)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Vascular & Interventional Radiology
Taxonomy
2085R0204X
License No.
R1614 (Texas)
Definition
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
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