MEDICARE: DR. ROBERT L. PATTERSON D.O.

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	207P00000X	Emergency Medicine Physician	A-1187-02	NM
2	208D00000X	General Practice Physician	A-1178-02	NM

General Provider Information

NPI Number	:	1437175171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT L. PATTERSON D.O.

Provider Business Mailing Address
First Line	:	4721 SUN CANYON CT
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-0978
Country	:	US
Telephone Number	:	505-522-0772
Fax Number	:

Provider Business Practice Location Address
First Line	:	3961 E LOHMAN AVE
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-8269
Country	:	US
Telephone Number	:	505-556-0200
Fax Number	:	505-556-0201

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	01/08/2024

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