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General NPI Number Information
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NPI Number | 1427046432
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Entity Type | Individual
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Provider Name | ROBERT LEWIS PATTERSON III PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 537 UNION AVE FL 2
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City | GRANTS PASS
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State | OR
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Zip | 97527-5543
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Country | US
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Telephone | 541-789-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 2825 E BARNETT RD # MSS
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City | MEDFORD
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State | OR
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Zip | 97504-8332
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Country | US
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Telephone | 541-789-4200
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Fax | 541-507-2051
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00756
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-00756
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA00756
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License Number State | OR
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