Provider Demographics
NPI:1033200571
Name:AL-ADSANI, PATRICIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:M
Last Name:AL-ADSANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8360 WHITE OWL CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-8051
Mailing Address - Country:US
Mailing Address - Phone:970-674-3153
Mailing Address - Fax:970-336-5000
Practice Address - Street 1:8360 WHITE OWL CT
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-8051
Practice Address - Country:US
Practice Address - Phone:970-674-3153
Practice Address - Fax:970-336-5000
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-243592084P0804X
IA314562084P0800X, 2084P0804X
CO503272084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100128760BMedicaid
IA0249649Medicaid
F20823Medicare UPIN
KS100128760BMedicaid
IAI20789Medicare PIN