Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | F7033 | TX |
N | 207V00000X | Obstetrician & Gynecologist | F7033 | TX |
Y | 207VX0201X | Gynecologic Oncologist | ME79208 | FL |
NPI | 1205813854 |
---|---|
Provider Name | Dr. Thomas J Patton JR. |
First Address | Pensacola, FL 32501-6339 |
Second Address | Pensacola, FL 32501-6339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2005 |
Last Update Date | 29/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002227900 | (05) | FL |
148H1 | BCBSFL (01) | FL |