MEDICARE: MS. COLLEEN HILL PATTON PA

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	363A00000X	Physician Assistant	103689	NC
2	363AM0700X	Medical Physician Assistant	0110003919	VA
3	363A00000X	Physician Assistant	3565	SC

General Provider Information

NPI Number	:	1902160930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. COLLEEN HILL PATTON PA

Provider Business Mailing Address
First Line	:	45 HOSPITAL CENTER CMNS
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29926-2837
Country	:	US
Telephone Number	:	843-689-2895
Fax Number	:	843-689-9270

Provider Business Practice Location Address
First Line	:	100 BUCKWALTER PLACE BLVD STE 130
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-5023
Country	:	US
Telephone Number	:	843-836-7101
Fax Number	:	843-836-7112

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

Provider Enumeration Date	:	06/25/2012
Last Update Date	:	10/20/2021

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