Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CHIR009441 | GA |
NPI | 1154874089 |
---|---|
Provider Name | Dr. Frank Patterson |
First Address | Marietta, GA 30062-3585 |
Second Address | Marietta, GA 30062-3585 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2016 |
Last Update Date | 27/07/2016 |