Provider Demographics
NPI:1164445813
Name:PATTERSON, JAMES H JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:PATTERSON
Suffix:JR
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 1:104 FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-8842
Mailing Address - Country:US
Mailing Address - Phone:859-887-2441
Mailing Address - Fax:859-885-3323
Practice Address - Street 1:104 FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-8842
Practice Address - Country:US
Practice Address - Phone:859-887-2441
Practice Address - Fax:859-885-3323
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY28217207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64282171Medicaid
KY9358803Medicare PIN
KY64282171Medicaid