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General NPI Number Information
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NPI Number | 1104829399
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Entity Type | Individual
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Provider Name | JAY R PATTERSON MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 1801 BARRS ST STE 500
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4746
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Country | US
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Telephone | 904-388-1820
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Fax | 904-388-1827
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Provider Business Mailing Address
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Address Line | 562 PARK ST STE 310
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City | JACKSONVILLE
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State | FL
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Zip | 32204-2962
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Country | US
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Telephone | 904-633-2021
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Fax | 904-633-9793
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | ME62363
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 030852
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License Number State | GA
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