MEDICARE: MR. MATTHEW R PATTON PA

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	363A00000X	Physician Assistant	2664	OK

General Provider Information

NPI Number	:	1164758496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW R PATTON PA

Provider Business Mailing Address
First Line	:	720 W 71ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74132-1895
Country	:	US
Telephone Number	:	918-760-0700
Fax Number	:	918-900-2654

Provider Business Practice Location Address
First Line	:	720 W 71ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74132-1895
Country	:	US
Telephone Number	:	918-760-0700
Fax Number	:	918-900-2654

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

Provider Enumeration Date	:	10/21/2009
Last Update Date	:	12/08/2025

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