Organization
J. KELLY PATTERSON, M.D., P.S.C.
Active
Organization
J. KELLY PATTERSON, M.D., P.S.C.
Active
Other names
Patterson Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK KELLY PATTERSON M.D. (OWNER)
(270) 586-5888
Entity
Organization
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 BLUE CROSS
KY
01
—
000000305382
PROVIDER NUMBER
KY
01
—
110158592
RAILROAD MEDICARE
KY
01
—
18D0712268
CLIA NUMBER
KY
05
—
64272131
—
KY
05
—
65929200
—
KY
Enumeration date
05/29/2007
Last updated
06/21/2018
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