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1679720726
WAYMOND JAY PETTIT
DECATUR, IL
NPI
1679720726
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Y00000X Otolaryngology
(Licence: IL 036051290)
Enumeration Date
2008-08-20
Last Update Date
2008-08-20
Business Address
DR. WAYMOND JAY PETTIT M.D.
3620 S TAYLOR RD
DECATUR, IL 62521-9015
Phone number: 217-454-0022
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Mailing Address
DR. WAYMOND JAY PETTIT M.D.
451 E 1000 N
LA PORTE, IN 46350-8638
Phone number: 219-778-8524
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