Individual
BRENDA C PATTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1003 WILLOW CREEK RD, PRESCOTT, AZ 86301
(928) 771-5470
(928) 771-5471
Mailing address
PO BOX 11720, PRESCOTT, AZ 86304
(928) 771-5759
(929) 771-5471
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
22231
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323569
—
AZ
01
—
3235690001
APIPA
—
05
—
913113000
—
FL
01
—
AZ0744390
BCBS
AZ
01
—
P00098328
RAILROAD MEDICARE
—
Enumeration date
09/28/2005
Last updated
12/05/2013
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