MEDICARE: PATTON DOUGLAS GRAHAM NP-C

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	363LF0000X	Family Nurse Practitioner	20562	TN

General Provider Information

NPI Number	:	1992072524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATTON DOUGLAS GRAHAM NP-C

Provider Business Mailing Address
First Line	:	6419 ARNO COLLEGE GROVE RD
Second Line	:
City	:	COLLEGE GROVE
State	:	TN
Zip	:	37046-9130
Country	:	US
Telephone Number	:	615-772-4710
Fax Number	:

Provider Business Practice Location Address
First Line	:	6419 ARNO COLLEGE GROVE RD
Second Line	:
City	:	COLLEGE GROVE
State	:	TN
Zip	:	37046-9130
Country	:	US
Telephone Number	:	615-772-4710
Fax Number	:

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

Provider Enumeration Date	:	11/28/2011
Last Update Date	:	05/24/2025

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