Basic Information
Provider Information
NPI: 1306593777
EntityType: 2
ReplacementNPI:  
OrganizationName: PATTERSON FAMILY MEDICINE & OBSTETRICS PLLC
LastName:  
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Mailing Information
Address1: 114 N JEFFERSON AVE
Address2:  
City: ELK CITY
State: OK
PostalCode: 736444746
CountryCode: US
TelephoneNumber: 4055785400
FaxNumber:  
Practice Location
Address1: 114 N JEFFERSON AVE
Address2:  
City: ELK CITY
State: OK
PostalCode: 736444746
CountryCode: US
TelephoneNumber: 4055785400
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/07/2022
LastUpdateDate: 03/07/2022
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: PATTERSON
AuthorizedOfficialFirstName: NATALIE
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AuthorizedOfficialTitleorPosition: PHYSICIAN/OWNER
AuthorizedOfficialTelephone: 4055785400
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: DO
NPICertificationDate: 03/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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