Provider Demographics
NPI:1295181600
Name:BARTHOLOMEW, PATRICK ALLEN JR (DPM)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:ALLEN
Last Name:BARTHOLOMEW
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-0001
Mailing Address - Country:US
Mailing Address - Phone:570-271-6211
Mailing Address - Fax:
Practice Address - Street 1:530 SE 16TH PL STE A
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1656
Practice Address - Country:US
Practice Address - Phone:239-430-3668
Practice Address - Fax:239-692-9436
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4079213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery