Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 17032 | MS |
NPI | 1073545281 |
---|---|
Provider Name | Dr. Michael C Patterson |
First Address | Hattiesburg, MS 39401-8246 |
Second Address | Hattiesburg, MS 39401-8246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 23/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H25740 | (02) | MS |