Healthcare Provider Details

I. General information

NPI: 1073573226
Provider Name (Legal Business Name): JOHN BYRON PATTERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 01/27/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16000 JOHNSTON MEMORIAL DR SUITE 212A
ABINGDON VA
24211-7664
US

IV. Provider business mailing address

16000 JOHNSTON MEMORIAL DR SUITE 212A
ABINGDON VA
24211-7664
US

V. Phone/Fax

Practice location:
  • Phone: 276-258-3740
  • Fax: 276-258-3745
Mailing address:
  • Phone: 276-258-3740
  • Fax: 276-258-3745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number51356
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number204537
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0101255806
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number51356
License Number StateTN
# 5
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101255806
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: