Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 00017743 | AL |
NPI | 1003873167 |
---|---|
Provider Name | Yolanda A Patterson |
First Address | Troy, AL 36081-0928 |
Second Address | Troy, AL 36081-3058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E97718 | (02) |