MEDICARE: JOSEPH PATRICK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	47085	TN
2	207Q00000X	Family Medicine Physician	LL29777	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013112119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH PATRICK MD

Provider Business Mailing Address
First Line	:	2595 CENTRAL AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38104-5905
Country	:	US
Telephone Number	:	901-260-8551
Fax Number	:	901-260-8590

Provider Business Practice Location Address
First Line	:	2569 DOUGLASS AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38114-2532
Country	:	US
Telephone Number	:	901-271-6200
Fax Number	:	901-271-6249

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	03/15/2012

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Directions to “ JOSEPH PATRICK MD” Practice Location

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