Basic Information
| Provider Information | |||||||||
| NPI: | 1992747794 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JARVIS | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 776351 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606776351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025889490 | ||||||||
| FaxNumber: | 5022725116 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 E CHESTNUT ST STE 303 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402021831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026295552 | ||||||||
| FaxNumber: | 5026293132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2006 | ||||||||
| LastUpdateDate: | 11/01/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 34908 | KY | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | 34908 | KY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000332130 | 01 | KY | ANTHEM | OTHER | 3690745000 | 01 | KY | PASSPORT ADVANTAGE- NORTON INPATIENT SPECIALISTS | OTHER | 7694550 | 01 | KY | AETNA PPO | OTHER | 000000587287 | 01 | KY | ANTHEM- NORTON INPATIENT SPECIALISTS | OTHER | 64057029 | 05 | KY | MEDICAID | 000023034P | 01 | KY | HUMANA- NORTON INPATIENT SPECIALISTS | OTHER | 099258 | 01 | KY | SIHO- NORTON INPATIENT SPECIALISTS | OTHER | 200399030 | 01 | KY | HEALTHY INDIANA PLAN- NORTON INPATIENT SPECIALISTS | OTHER | 3426812 | 01 | KY | AETNA HMO ONLY | OTHER | 200399030 | 01 | KY | MD WISE- NORTON INPATIENT SPECIALISTS | OTHER | 50020903 | 01 | KY | PASSPORT- NORTON INPATIENT SPECIALISTS | OTHER | 200399030 | 01 | KY | ANTHEM INDIANA MEDICAID- NORTON INPATIENT SPECIALISTS | OTHER | 2234475 | 01 | KY | UNITED HEALTH CARE | OTHER | 64057029 | 01 | KY | MEDICAID KY- NORTON INPATIENT SPECIALISTS | OTHER | 2179941 | 01 | FIRST HEALTH | OTHER | 2446133000 | 01 | KY | PASSPORT ADVANTAGE | OTHER | 4130645 | 01 | KY | CIGNA- NORTON INPATIENT SPECIALISTS | OTHER | 4130645 | 01 | CIGNA | OTHER | 200399030 | 01 | IN | MEDICAID- NORTON INPATIENT SPECIALISTS | OTHER | 50004781 | 01 | KY | PASSPORT | OTHER | P00655702 | 01 | KY | RAILROAD MEDICARE- NORTON INPATIENT SPECIALISTS | OTHER | 00533072 | 01 | KY | MEDICARE- NORTON INPATIENT SPECIALISTS | OTHER | 200399030 | 05 | IN | MEDICAID |