Individual
PATRICK EVERETT MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1407 N THORNTON AVE, DALTON, GA 30720
(706) 278-7224
Mailing address
PO BOX 2546, DALTON, GA 30720
(706) 259-4428
(706) 226-2283
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
053786
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350073628F
—
GA
01
—
P00437075
RAILROAD MEDICARE
GA
Enumeration date
01/22/2007
Last updated
07/28/2010
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