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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