Provider Demographics
NPI:1164541652
Name:PATTON, JOHN H (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:PATTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 SPRINGDALE RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-2419
Mailing Address - Country:US
Mailing Address - Phone:404-378-6827
Mailing Address - Fax:
Practice Address - Street 1:1328 PEACHTREE ST NE
Practice Address - Street 2:SUITE B317
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3209
Practice Address - Country:US
Practice Address - Phone:404-228-7777
Practice Address - Fax:404-228-7769
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT543106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist