Provider Demographics
NPI:1154471035
Name:PATTERSON, MICHAEL ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3189 KIRBY WHITTEN RD STE 105
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2855
Mailing Address - Country:US
Mailing Address - Phone:901-213-0305
Mailing Address - Fax:901-273-3015
Practice Address - Street 1:3189 KIRBY WHITTEN RD STE 105
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2855
Practice Address - Country:US
Practice Address - Phone:901-213-0305
Practice Address - Fax:901-273-3015
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000293802084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3837411Medicare ID - Type Unspecified
TNA98473Medicare UPIN