Organization
PATTERSON FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHEAL A PATTERSON D.O. (PRESIDENT/PHYSICIAN)
(636) 464-4000
Entity
Organization
Contact information
Practice address
1502 PREHISTORIC HILL DR, IMPERIAL, MO 63052-2288
(636) 464-4000
(636) 464-4911
Mailing address
PO BOX 998, IMPERIAL, MO 63052-0998
(636) 464-4000
(636) 464-4911
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
106797
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG3276
RAILROAD MEDICARE
MO
Enumeration date
11/01/2006
Last updated
02/06/2008
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