Individual
MR. ALEXANDER GARY PATTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2210 WILBORN AVE, SOUTH BOSTON, VA 24592-1630
(434) 575-5864
Mailing address
2210 WILBORN AVE, SOUTH BOSTON, VA 24592-1630
(434) 575-5864
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110008352
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110-008352
PHYSICIAN ASSISTANT LICENSE
VA
01
—
1190095
NCCPA CERTIFICATION
—
Enumeration date
09/30/2021
Last updated
02/19/2024
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