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General NPI Number Information
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NPI Number | 1629066915
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Entity Type | Individual
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Provider Name | PATRICIA FAYE PATTERSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/11/2005
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 1205 VAN STREAT HWY
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City | NICHOLLS
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State | GA
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Zip | 31554-5025
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Country | US
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Telephone | 912-345-2474
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Fax | 912-345-5620
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Provider Business Mailing Address
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Address Line | 302 S WAYNE ST
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City | ALMA
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State | GA
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Zip | 31510-2922
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Country | US
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Telephone | 912-632-8961
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Fax | 912-632-5000
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 031176
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License Number State | GA
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