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NPI 1972123222

NPI 1972123222 : AUSTIN M PATTERSON DO : MARIETTA, OH

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General NPI Number Information
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    NPI Number           |    1972123222
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    Entity Type          |    Individual 
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    Provider Name        |    AUSTIN M PATTERSON DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/16/2020
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    Last Update Date     |    09/30/2024
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Provider Practice Location Address
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    Address Line         |    802 WAYNE ST STE 200 
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    City                 |    MARIETTA
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    State                |    OH
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    Zip                  |    45750-3300
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    Country              |    US
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    Telephone            |    740-374-6030
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    Fax                  |    740-374-6029
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Provider Business Mailing Address
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    Address Line         |    802 WAYNE ST STE 200 
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    City                 |    MARIETTA
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    State                |    OH
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    Zip                  |    45750-3300
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    Country              |    US
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    Telephone            |    740-374-6030
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    Fax                  |    740-374-6029
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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        |    207QS0010X
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    Taxonomy Name        |    Sports Medicine (Family Medicine) Physician
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    License Number       |    4299
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    License Number State |    WV
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Taxonomy #2
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    Taxonomy Code        |    207QS0010X
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    Taxonomy Name        |    Sports Medicine (Family Medicine) Physician
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    License Number       |    34.017469
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    License Number State |    OH
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