Provider Demographics
NPI:1003974486
Name:PATTON, JOHN WILLIAM III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:PATTON
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:39780 ROAD G
Mailing Address - City:MANCOS
Mailing Address - State:CO
Mailing Address - Zip Code:81328
Mailing Address - Country:US
Mailing Address - Phone:970-533-1970
Mailing Address - Fax:970-533-1261
Practice Address - Street 1:1311 N MILDRED ST NE
Practice Address - Street 2:SW MEMORIAL HOSPITAL
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321
Practice Address - Country:US
Practice Address - Phone:950-565-6666
Practice Address - Fax:970-564-2049
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CO38470207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84239361Medicaid
CO84239361Medicaid