Individual
TREVER L PATTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
7807 E FUNSTON ST, WICHITA, KS 67207-3123
(316) 636-1188
(316) 636-1190
Mailing address
7807 E FUNSTON ST, WICHITA, KS 67207-3123
(316) 636-1188
(316) 636-1190
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1234
KS
103TC0700X
Clinical Psychologist
Primary
PSY-202376
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16849372
MEDICARE GROUP PIN
ID
01
—
N6300
BLUE CROSS
ID
Enumeration date
06/20/2006
Last updated
02/12/2009
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