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Individual

MR. THOMAS S PATTERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M7458
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010004870
BLUE SHIELD
ID
01
000010034815
BLUE SHIELD
ID
05
1467442467
ID
01
370014214
RAILROAD MEDICARE
ID
01
45187
BLUE CROSS
ID
05
805185100
ID
01
806353600
HEALTHY CONNECTIONS
ID
01
DM743
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
08/15/2016
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