Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 4487 | OK |
Y | 213EG0000X | General Practice | 4487 | OK |
NPI | 1003815754 |
---|---|
Provider Name | Dr. Larry K Patterson |
First Address | Okemah, OK 74859-0347 |
Second Address | Okemah, OK 74859-2607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2005 |
Last Update Date | 08/07/2007 |