Provider Demographics
NPI:1154859189
Name:PATTERSON, NATALIE (DO)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 W 2ND ST STE D
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73644-4328
Mailing Address - Country:US
Mailing Address - Phone:580-339-8089
Mailing Address - Fax:877-592-0771
Practice Address - Street 1:114 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-4746
Practice Address - Country:US
Practice Address - Phone:405-578-5400
Practice Address - Fax:877-728-4556
Is Sole Proprietor?:No
Enumeration Date:2017-06-04
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6470207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200861670AMedicaid
OK2C4814OtherOK MEDICARE