Patterson Family Practice

Organization Active NPI Family Medicine Physician · Imperial, MO

NPI 1861579013 · NPPES record last updated Feb 6, 2008

Key facts

NPI
1861579013
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
106797 (MO)
Legal business name
PATTERSON FAMILY PRACTICE
Practice address
1502 Prehistoric Hill Dr
Imperial, MO 63052-2288
Phone
(636) 464-4000
Fax
(636) 464-4911
NPI assigned
Nov 1, 2006
Organization subpart
No

Authorized official

Name
Micheal A Patterson, D.O.
Title
President/Physician
Phone
(636) 464-4000

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 106797 MO Yes

Addresses

Primary practice location

1502 Prehistoric Hill Dr
Imperial, MO 63052-2288

Mailing address

PO Box 998
Imperial, MO 63052-0998
Phone (636) 464-4000

Other identifiers

IdentifierTypeStateIssuer
DG3276OtherMORAILROAD MEDICARE

Other providers in Imperial, MO

All providers in Imperial, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.