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General NPI Number Information
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NPI Number | 1568463404
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Entity Type | Individual
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Provider Name | ELIZABETH DIANE PATTON RPH
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Gender | Female
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 02/05/2013
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Provider Practice Location Address
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Address Line | 916 LOGANVILLE HWY
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City | BETHLEHEM
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State | GA
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Zip | 30620-2144
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Country | US
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Telephone | 770-307-1637
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Fax | 770-307-1746
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Provider Business Mailing Address
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Address Line | 1011 OVERLOOK DR
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City | BOGART
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State | GA
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Zip | 30622-2474
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Country | US
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Telephone | 706-338-0335
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 15522
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License Number State | GA
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