Provider Demographics
NPI:1316576093
Name:PATTERSON, TAYLOR ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:ANDREW
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10230 W HAPPY VALLEY PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-4692
Mailing Address - Country:US
Mailing Address - Phone:623-561-3030
Mailing Address - Fax:623-825-5630
Practice Address - Street 1:10230 W HAPPY VALLEY PKWY UNIT 100-200
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-4691
Practice Address - Country:US
Practice Address - Phone:623-561-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-05
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ010491207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program