Individual
DR. JACK K PATTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
208 SOUTH MAIN, FRANKLIN, KY 42134
(270) 813-2520
(270) 713-0234
Mailing address
208 S MAIN, PO 385, FRANKLIN, KY 42134
(270) 813-2520
(270) 713-0234
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27213
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049404
ANTHEM BC
KY
01
—
000000305382
ANTHEM BC PHYSICAL THERAP
KY
01
—
61-1175802
TAX ID
—
05
—
64272131
—
KY
05
—
65929200
—
KY
Enumeration date
11/14/2006
Last updated
12/27/2017
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