Healthcare Provider Details

I. General information

NPI: 1639277429
Provider Name (Legal Business Name): DONALD G PATTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 MAPLE LN
ASHLAND WI
54806-3610
US

IV. Provider business mailing address

163 E HAGERMAN LAKE RD
IRON RIVER MI
49935-7923
US

V. Phone/Fax

Practice location:
  • Phone: 715-685-5500
  • Fax: 715-682-4022
Mailing address:
  • Phone: 906-265-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberBP2711605
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number31958
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301061515
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberBP2711605
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301061515
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: