# PATTERSON FAMILY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861579013
- **Authorized official:** MICHEAL A PATTERSON D.O. (PRESIDENT/PHYSICIAN)
- **Authorized official phone:** (636) 464-4000

## Contact information

- **Practice address:** 1502 PREHISTORIC HILL DR, IMPERIAL, MO 63052-2288
- **Practice address phone:** (636) 464-4000
- **Practice address fax:** (636) 464-4911
- **Mailing address:** PO BOX 998, IMPERIAL, MO 63052-0998
- **Mailing address phone:** (636) 464-4000
- **Mailing address fax:** (636) 464-4911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 106797 | MO | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 02/06/2008