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NPI Code Detail

MEDICARE: MR. JACK T PATTON MD

MEDICARE: MR. JACK T PATTON 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 PhysicianG15827CA

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 : 1437192739
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JACK T PATTON MD
Provider Business Mailing Address
First Line : 199 W SHIELDS AVE
Second Line :
City : FRESNO
State : CA
Zip : 93705-4102
Country : US
Telephone Number : 559-225-4706
Fax Number : 559-225-4710
Provider Business Practice Location Address
First Line : 199 W SHIELDS AVE
Second Line :
City : FRESNO
State : CA
Zip : 93705-4102
Country : US
Telephone Number : 559-225-4706
Fax Number : 559-225-4710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 02/27/2015

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