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General NPI Number Information
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NPI Number | 1649443672
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Entity Type | Organization
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Legal Business Name | GREGORY A PATCHEN DO PC
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 2058 S DOBSON RD SUITE 15
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City | MESA
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State | AZ
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Zip | 85202-6454
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Country | US
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Telephone | 480-839-5800
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Fax | 480-839-5804
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Provider Business Mailing Address
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Address Line | 1953 S COMANCHE DR
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City | CHANDLER
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State | AZ
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Zip | 85286-6466
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Country | US
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Telephone | 480-839-5800
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Fax | 480-839-5804
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Authorized Official
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Title or Position | PHYSICIAN
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Name | GREGORY A PATCHEN
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Credential | DO
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Telephone | 480-839-5800
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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 | AZ2996
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License Number State | AZ
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