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General NPI Number Information
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NPI Number | 1649238569
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Entity Type | Individual
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Provider Name | C. STEPHEN PATTERSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1122 NW GARDEN VALLEY BLVD SUITE 107
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City | ROSEBURG
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State | OR
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Zip | 97470-1930
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Country | US
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Telephone | 541-673-2455
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Fax | 541-673-2456
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Provider Business Mailing Address
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Address Line | 1122 NW GARDEN VALLEY BLVD SUITE 107
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City | ROSEBURG
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State | OR
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Zip | 97470-1930
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Country | US
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Telephone | 541-673-2455
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Fax | 541-673-2456
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MDO7948
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License Number State | OR
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