Organization
PATTERSON GASTROENTEROLOGY PLLC
Active
Other names
Patterson Pediatric Gastroenterology PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD LEE PATTERSON JR. MEDICAL DOCTOR (OWNER/CEO)
(602) 283-3165
Entity
Organization
Contact information
Practice address
515 W BUCKEYE RD, SUITE 105, PHOENIX, AZ 85003-2647
(602) 283-3165
(602) 283-3612
Mailing address
PO BOX 90482, PHOENIX, AZ 85066-0482
(602) 283-3165
(602) 283-3612
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
20901
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127820
—
AZ
Enumeration date
12/09/2011
Last updated
12/09/2011
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