Individual
TRAVIS PATTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
444 CLINCHFIELD ST STE 103, KINGSPORT, TN 37660-3859
(423) 578-1518
(423) 230-6349
Mailing address
509 MED TECH PKWY STE 100, JOHNSON CITY, TN 37604-2579
(423) 302-6565
(423) 952-2175
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110004732
VA
363A00000X
Physician Assistant
4597
TN
363AS0400X
Surgical Physician Assistant
Primary
0110004732
VA
363AS0400X
Surgical Physician Assistant
4597
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174924922
—
VA
01
—
P01552889
RAILROAD MEDICARE
VA
05
—
Q031354
—
TN
Enumeration date
09/11/2014
Last updated
11/19/2025
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