1114118122 NPI number — JOAN BREDER PATTERSON MD

Table of content: JOAN BREDER PATTERSON MD (NPI 1114118122)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114118122 NPI number — JOAN BREDER PATTERSON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATTERSON
Provider First Name:
JOAN
Provider Middle Name:
BREDER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BREDER
Provider Other First Name:
JOAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1114118122
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/03/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HH EMERGENCY PHYSICIANS GROUP
Provider Second Line Business Mailing Address:
101 SIVLEY RD SW
Provider Business Mailing Address City Name:
HUNTSVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-265-9889
Provider Business Mailing Address Fax Number:
865-271-6601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HH EMERGENCY PHYSICIANS GROUP
Provider Second Line Business Practice Location Address:
101 SIVLEY RD SW
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-265-9889
Provider Business Practice Location Address Fax Number:
865-271-6601
Provider Enumeration Date:
08/05/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  32034 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)