MEDICARE: JOSEPH R PATTISON M D P A

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	ME46221	FL

General Provider Information

NPI Number	:	1285909069
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH R PATTISON M D P A

Provider Business Mailing Address
First Line	:	2561 OAK ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4559
Country	:	US
Telephone Number	:	904-384-6009
Fax Number	:	904-384-5354

Provider Business Practice Location Address
First Line	:	2561 OAK ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4559
Country	:	US
Telephone Number	:	904-384-6009
Fax Number	:	904-384-5354

Authorized Official
Title or Position	:	MD/OWNER
Name	:	JOSEPH R PATTISON
Credential	:	MD
Telephone Number	:	904-384-6009

Provider Enumeration Date	:	03/13/2012
Last Update Date	:	03/13/2012

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