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General NPI Number Information
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NPI Number | 1235304213
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Entity Type | Organization
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Legal Business Name | JOHN D PATSIMAS MD
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 100 WILLIAM NORTHERN BLVD
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City | TULLAHOMA
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State | TN
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Zip | 37388-4754
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Country | US
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Telephone | 931-454-0489
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Fax | 931-454-2348
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Provider Business Mailing Address
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Address Line | 100 WILLIAM NORTHERN BLVD
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City | TULLAHOMA
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State | TN
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Zip | 37388-4754
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Country | US
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Telephone | 931-454-0489
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Fax | 931-454-2348
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | JOHN D PATSIMAS
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Credential | MD
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Telephone | 931-454-0489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD024651
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License Number State | TN
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