1649367194 NPI number — DR. JOHN PATRICK PATTON DPM

Table of content: DR. JOHN PATRICK PATTON DPM (NPI 1649367194)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649367194 NPI number — DR. JOHN PATRICK PATTON DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATTON
Provider First Name:
JOHN
Provider Middle Name:
PATRICK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649367194
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1775 BROWNING WAY
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
ELKO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89801-8338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-753-4044
Provider Business Mailing Address Fax Number:
775-753-5694

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1775 BROWNING WAY
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
ELKO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89801-8338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-753-4044
Provider Business Practice Location Address Fax Number:
775-753-5694
Provider Enumeration Date:
10/06/2006

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: 213ES0103X , with the licence number:  9506 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P00930268 . This is a "RAILROAD MEDICARE PIN" identifier . This identifiers is of the category "OTHER".




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