Healthcare Provider Details

I. General information

NPI: 1841285368
Provider Name (Legal Business Name): ALLEN J PATTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 N E ST SUITE 231
PENSACOLA FL
32501-6396
US

IV. Provider business mailing address

1717 N E ST SUITE 231
PENSACOLA FL
32501-6396
US

V. Phone/Fax

Practice location:
  • Phone: 850-444-4785
  • Fax: 850-434-2647
Mailing address:
  • Phone: 850-444-4717
  • Fax: 850-434-2647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number0021360
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number8124
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: