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General NPI Number Information
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NPI Number | 1790774651
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Entity Type | Individual
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Provider Name | JAMES W. PATTERSON P.A.
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Gender | Male
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 300 SINGLETON RIDGE RD
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City | CONWAY
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State | SC
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Zip | 29526-9142
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Country | US
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Telephone | 843-347-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 2156 LONGWOOD LAKES DR
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City | MYRTLE BEACH
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State | SC
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Zip | 29579-7529
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Country | US
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Telephone | 843-360-0067
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA1561
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License Number State | SC
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