MEDICARE: PATRICK T GLEASON M.D.

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	207R00000X	Internal Medicine Physician	76720	GA
2	207RC0000X	Cardiovascular Disease Physician	76720	GA

General Provider Information

NPI Number	:	1144580184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK T GLEASON M.D.

Provider Business Mailing Address
First Line	:	101 WOODRUFF CIRCLE WMB 319
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-0001
Country	:	US
Telephone Number	:	404-727-4724
Fax Number	:	404-712-8335

Provider Business Practice Location Address
First Line	:	550 PEACHTREE ST. NE
Second Line	:	DAVIS FISCHER BLDG, SUITE 4331
City	:	ATLANTA
State	:	GA
Zip	:	30308
Country	:	US
Telephone Number	:	404-778-6070
Fax Number	:	404-686-1739

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

Provider Enumeration Date	:	05/24/2012
Last Update Date	:	01/14/2026

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