Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | DO188922 | OR |
Y | 207QS0010X | Family Doctor - Sports Medicine | 286638 | MA |
NPI | 1184036337 |
---|---|
Provider Name | Dr. William Lyle Patterson JR. |
First Address | Scituate, MA 02066-4533 |
Second Address | Pembroke, MA 02359-1966 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2014 |
Last Update Date | 27/04/2021 |