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NPI Code Detail

MEDICARE: DR. JOHNEQUIA PATTERSON MD

MEDICARE: DR. JOHNEQUIA PATTERSON 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
1207Q00000XFamily Medicine Physician66499TN

Other Identifiers

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

General Provider Information

NPI Number : 1164983789
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHNEQUIA PATTERSON MD
Provider Business Mailing Address
First Line : 207 HIGHWAY 52 BYP W
Second Line :
City : LAFAYETTE
State : TN
Zip : 37083-1728
Country : US
Telephone Number : 615-688-2273
Fax Number :
Provider Business Practice Location Address
First Line : 207 HIGHWAY 52 BYP W
Second Line :
City : LAFAYETTE
State : TN
Zip : 37083-1728
Country : US
Telephone Number : 615-688-2273
Fax Number : 615-688-2271
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2019
Last Update Date : 02/05/2025

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