Organization
TREVER PATTON, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREVER L PATTON PH.D. (PRESIDENT)
(316) 636-1188
Entity
Organization
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
103TC0700X
Clinical Psychologist
Primary
PSY202376
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010160661
BLUE SHIELD
ID
01
—
1013952134
INDIVIDUAL NPI
ID
01
—
16849372
MEDICARE GROUP PIN
ID
01
—
N6300
BLUE CROSS
ID
Enumeration date
11/14/2007
Last updated
02/11/2009
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