Individual
WILFORD J PATTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M D
Contact information
Practice address
106 CLINTON PKWY, CLINTON, MS 39056-4730
(601) 924-9005
(601) 925-9463
Mailing address
1151 N STATE ST, SUITE 408, JACKSON, MS 39202-2407
(601) 924-9005
(601) 925-9463
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05661
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00012345
—
MS
01
—
168390703
US DEPT OF LABOR
MS
01
—
4225044
AETNA
MS
01
—
753068151
MS HEALTH PARTNERS
MS
01
—
753068151001
TRICARE
MS
01
—
P00062075
RR MEDICARE
MS
Enumeration date
03/16/2006
Last updated
09/26/2008
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