Provider Demographics
NPI:1003904970
Name:PATTERSON, SCOTT B (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:B
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-3474
Mailing Address - Fax:239-343-2968
Practice Address - Street 1:2780 CLEVELAND AVE STE 702
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-5857
Practice Address - Country:US
Practice Address - Phone:239-343-3474
Practice Address - Fax:239-343-2968
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS119312086S0127X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102038Medicaid
AL51548778Other3401 MED PK DR, BLDG 1, STE 103
AL102007Medicaid
FL008045300Medicaid
AL51548777Other575 STANTON RD
AL102008Medicaid
AL51548771Other1720 CENTER ST., STE 103
AL51548777Other575 STANTON RD
AL102038Medicaid