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NPI Code Detail

MEDICARE: JOHN D PATSIMAS MD

MEDICARE: JOHN D PATSIMAS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD024651TN

General Provider Information

NPI Number : 1235304213
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN D PATSIMAS MD
Provider Business Mailing Address
First Line : 100 WILLIAM NORTHERN BLVD
Second Line :
City : TULLAHOMA
State : TN
Zip : 37388-4754
Country : US
Telephone Number : 931-454-0489
Fax Number : 931-454-2348
Provider Business Practice Location Address
First Line : 100 WILLIAM NORTHERN BLVD
Second Line :
City : TULLAHOMA
State : TN
Zip : 37388-4754
Country : US
Telephone Number : 931-454-0489
Fax Number : 931-454-2348
Authorized Official
Title or Position : MEDICAL DOCTOR
Name : JOHN D PATSIMAS
Credential : MD
Telephone Number : 931-454-0489
Provider Enumeration Date : 04/29/2008
Last Update Date : 06/06/2008

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