MEDICARE: ALLISON PATTON

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	183500000X	Pharmacist	2015022702	MO

General Provider Information

NPI Number	:	1265815120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON PATTON

Provider Business Mailing Address
First Line	:	124 S MADISON AVE
Second Line	:
City	:	AURORA
State	:	MO
Zip	:	65605-1427
Country	:	US
Telephone Number	:	417-678-4136
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 S MADISON AVE
Second Line	:
City	:	AURORA
State	:	MO
Zip	:	65605-1427
Country	:	US
Telephone Number	:	417-678-4136
Fax Number	:

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

Provider Enumeration Date	:	07/09/2015
Last Update Date	:	04/14/2017

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Directions to “ ALLISON PATTON ” Practice Location

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