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General NPI Number Information
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NPI Number | 1295181600
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Entity Type | Individual
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Provider Name | PATRICK ALLEN BARTHOLOMEW JR. DPM
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Gender | Male
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 11/14/2019
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Provider Practice Location Address
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Address Line | 530 SE 16TH PL STE A
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City | CAPE CORAL
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State | FL
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Zip | 33990-1656
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Country | US
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Telephone | 239-430-3668
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Fax | 239-692-9436
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Provider Business Mailing Address
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Address Line | GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-0001
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Country | US
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Telephone | 570-271-6211
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Fax |
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO4079
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License Number State | FL
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