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NPI Code Detail

MEDICARE: DR. JORDAN TRAVIS PATTERSON DO

MEDICARE: DR. JORDAN TRAVIS PATTERSON DO
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 Physician34.018085OH
2208600000XSurgery Physician5151015158MI

General Provider Information

NPI Number : 1275206088
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORDAN TRAVIS PATTERSON DO
Provider Business Mailing Address
First Line : 18901 LAKE SHORE BLVD
Second Line :
City : EUCLID
State : OH
Zip : 44119-1078
Country : US
Telephone Number : 216-692-1122
Fax Number : 216-427-9017
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2021
Last Update Date : 02/09/2026

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