Individual
JOSEPH PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2569 DOUGLASS AVE, MEMPHIS, TN 38114-2532
(901) 271-6200
(901) 271-6249
Mailing address
2595 CENTRAL AVE, MEMPHIS, TN 38104-5905
(901) 260-8551
(901) 260-8590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47085
TN
207Q00000X
Family Medicine Physician
LL29777
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1523531
—
TN
05
—
297770
—
SC
05
—
GP5425
—
SC
Enumeration date
06/19/2007
Last updated
03/15/2012
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