Individual
CODY E PATTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
151 N 4TH AVE, POCATELLO, ID 83201
(208) 269-7147
(208) 416-6522
Mailing address
151 N 4TH AVE, SUITE B, POCATELLO, ID 83201
(208) 269-7147
(208) 416-6522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01861
ID
207Q00000X
Family Medicine Physician
MRO-2046
ID
Other
Enumeration date
05/21/2021
Last updated
08/09/2024
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