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NPI Code Detail

MEDICARE: JARED J PATTON PA-C

MEDICARE: JARED J PATTON PA-C
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
1363A00000XPhysician Assistant10003135AIN
2363A00000XPhysician AssistantPA1669KY

Other Identifiers

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

General Provider Information

NPI Number : 1194004515
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARED J PATTON PA-C
Provider Business Mailing Address
First Line : PO BOX 635283
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-5283
Country : US
Telephone Number : 859-905-3070
Fax Number : 859-441-1348
Provider Business Practice Location Address
First Line : 605 MAN O WAR BOULEVARD
Second Line :
City : UNION
State : KY
Zip : 41091-2007
Country : US
Telephone Number : 859-578-5669
Fax Number : 859-384-0091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2011
Last Update Date : 10/28/2025

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