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Individual

JACOB F PATTERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
933 SELL AVE, SUITE A, CANON CITY, CO 81212-4900
(719) 275-0687
(719) 275-0690
Mailing address
PO BOX 310, CANON CITY, CO 81215-0310
(719) 275-0687
(719) 275-0690

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
30868
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01308683
CO
01
142165200
US DEPT OF LABOR
01
33886
ANTHEM BLUECROSSBLUE SHIE
CO
01
5502AMPR006855
ANTHEM BLUECROSSBLUESHIEL
01
841171832
TRICARE FOR LIFE WPS
01
P00262003
RAILROAD MEDICARE
CO
Enumeration date
01/03/2006
Last updated
02/18/2010
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