Healthcare Provider Details

I. General information

NPI: 1386684959
Provider Name (Legal Business Name): ANNA G PATTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 04/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 LOUISA RD
CATLETTSBURG KY
41129-1091
US

IV. Provider business mailing address

PO BOX 1595
ASHLAND KY
41105-1595
US

V. Phone/Fax

Practice location:
  • Phone: 606-739-6095
  • Fax: 606-739-8252
Mailing address:
  • Phone: 606-408-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number37960
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: