Organization
RUSSELL H. PATTERSON III, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL H PATTERSON III MD (CEO)
(901) 382-1200
Entity
Organization
Contact information
Practice address
6215 HUMPHREYS BLVD, SUITE 505, MEMPHIS, TN 38120-2367
(901) 382-1200
(901) 382-8070
Mailing address
PO BOX 2121, MEMPHIS, TN 38159-0001
(901) 382-1200
(901) 382-8070
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD0000006686
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4036248
BLUE SHIELD TN
TN
Enumeration date
09/29/2005
Last updated
09/07/2010
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