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Organization
WILLIAM G. PATRICK, M.D., P.C.
Active
Organization
WILLIAM G. PATRICK, M.D., P.C.
Active
Other names
Fayetteville Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM GLENN PATRICK M.D. (PRESIDENT)
(315) 637-9116
Entity
Organization
Contact information
Practice address
212 HIGHBRIDGE ST, SUITE A, FAYETTEVILLE, NY 13066-1979
(315) 637-9116
(315) 637-5224
Mailing address
212 HIGHBRIDGE ST, SUITE A, FAYETTEVILLE, NY 13066-1979
(315) 637-9116
(315) 637-5224
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1425781
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BPW1890
BCBS SUBMITTER ID
NY
Enumeration date
01/24/2007
Last updated
09/22/2011
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