Healthcare Provider Details

I. General information

NPI: 1285945410
Provider Name (Legal Business Name): ANTHONY B PATTERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 ANDREWS AVE
FORT RUCKER AL
36362
US

IV. Provider business mailing address

301 ANDREWS AVE
FORT RUCKER AL
36362
US

V. Phone/Fax

Practice location:
  • Phone: 800-261-7193
  • Fax:
Mailing address:
  • Phone: 800-261-7193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01070193A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: