Basic Information
| Provider Information | |||||||||
| NPI: | 1952320384 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATTERSON | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | R. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1 HOSPITAL DR | ||||||||
| Address2: | SUITE 306 | ||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178379350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705224110 | ||||||||
| FaxNumber: | 5707683911 | ||||||||
| Practice Location | |||||||||
| Address1: | 3 HOSPITAL DR STE 214 | ||||||||
| Address2: | |||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178379394 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705244242 | ||||||||
| FaxNumber: | 5705244201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 06/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 06/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD071842L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 50000682 | 01 | PA | KEYSTONE | OTHER | 0017815300006 | 05 | PA | MEDICAID | 55100C3AI | 01 | PA | GEISINGER | OTHER | H29126 | 01 | PA | HEALTH AMERICA | OTHER | P00165826 | 01 | PA | RAILROAD MEDICARE | OTHER | 676621 | 01 | PA | BLUE SHIELD | OTHER | 232809429 | 01 | PA | TRICARE | OTHER | 50000682 | 01 | PA | BLUE CROSS | OTHER | 118438701 | 01 | PA | DEPARTMENT OF LABOR | OTHER |