MEDICARE: JARED JAMES PATTERSON M.D.

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	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	ME162818	FL
2	207X00000X	Orthopaedic Surgery Physician	ME162818	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	QUCX5	OTHER	FL	BCBSFL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508897018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARED JAMES PATTERSON M.D.

Provider Business Mailing Address
First Line	:	3334 CAPITAL MEDICAL BLVD STE 400
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4470
Country	:	US
Telephone Number	:	850-877-8174
Fax Number	:	844-261-6839

Provider Business Practice Location Address
First Line	:	2011 HARRISON AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4545
Country	:	US
Telephone Number	:	850-691-4188
Fax Number	:

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	06/12/2023

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