Individual
DR. JOHN W PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 W GORDON ST, THOMASTON, GA 30286-3426
(706) 647-8111
(706) 647-4389
Mailing address
PO BOX 589, THOMASTON, GA 30286-0008
(706) 647-8111
(706) 647-4389
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
011438
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
520322900001
BLUE CROSS
GA
Enumeration date
06/16/2005
Last updated
07/08/2007
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