Provider Demographics
NPI:1023200920
Name:PATTERSON, CHAD O (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:O
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 406
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-0406
Mailing Address - Country:US
Mailing Address - Phone:606-886-8183
Mailing Address - Fax:606-886-0575
Practice Address - Street 1:400 UNIVERSITY DR
Practice Address - Street 2:SUITE 203
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-1080
Practice Address - Country:US
Practice Address - Phone:606-886-8183
Practice Address - Fax:606-886-0575
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY41195208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100064520Medicaid