Provider Demographics
NPI:1225648413
Name:PATTERSON, JAMES REGINALD JR
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:REGINALD
Last Name:PATTERSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 FORD DR APT 1214
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3956
Mailing Address - Country:US
Mailing Address - Phone:216-798-9736
Mailing Address - Fax:
Practice Address - Street 1:1990 FORD DR APT 1214
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-3956
Practice Address - Country:US
Practice Address - Phone:216-798-9736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide