Individual
CHARLES SCOTT PATTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8383 MILLICENT WAY, SHREVEPORT, LA 71115-5207
(318) 797-6661
(318) 795-8512
Mailing address
8383 MILLICENT WAY, SHREVEPORT, LA 71115-5207
(318) 797-6661
(318) 795-8512
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15779R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1529389
—
LA
01
—
15779R
MEDICAL LICENSE
LA
01
—
6498752001Q
CIGNA
LA
01
—
7273768
AETNA
—
01
—
P00351985
RR MCR
LA
Enumeration date
03/01/2006
Last updated
05/08/2024
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