Healthcare Provider Details

I. General information

NPI: 1255410635
Provider Name (Legal Business Name): JAMES MICHAEL PATTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2006
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 S GEORGE WASHINGTON DR
WICHITA KS
67211-3900
US

IV. Provider business mailing address

990 S GEORGE WASHINGTON DR
WICHITA KS
67211-3900
US

V. Phone/Fax

Practice location:
  • Phone: 316-686-2111
  • Fax: 316-686-3659
Mailing address:
  • Phone: 316-686-2111
  • Fax: 316-686-3659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4-18220
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number4-18220
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: