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General NPI Number Information
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NPI Number | 1285909069
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Entity Type | Organization
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Legal Business Name | JOSEPH R PATTISON M D P A
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Dates
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Enumeration Date | 03/13/2012
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 2561 OAK ST
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4559
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Country | US
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Telephone | 904-384-6009
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Fax | 904-384-5354
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Provider Business Mailing Address
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Address Line | 2561 OAK ST
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4559
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Country | US
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Telephone | 904-384-6009
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Fax | 904-384-5354
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Authorized Official
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Title or Position | MD/OWNER
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Name | JOSEPH R PATTISON
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Credential | MD
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Telephone | 904-384-6009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME46221
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License Number State | FL
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