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NPI Code Detail

MEDICARE: MICHAEL DAVID PATTERSON D.O.

MEDICARE: MICHAEL DAVID 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
1207W00000XOphthalmology PhysicianDO2931TN
2207R00000XInternal Medicine PhysicianLL1589SC

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 : 1851654867
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL DAVID PATTERSON D.O.
Provider Business Mailing Address
First Line : 15 IRIS LN
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-7528
Country : US
Telephone Number : 931-456-2728
Fax Number : 931-456-5446
Provider Business Practice Location Address
First Line : 15 IRIS LN
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-7528
Country : US
Telephone Number : 931-456-2728
Fax Number : 931-456-5446
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2012
Last Update Date : 07/13/2016

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