Provider Demographics
NPI:1326335852
Name:PATTERSON, ZACHARY SEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:SEAN
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:155 CALLE PORTAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2900
Mailing Address - Country:US
Mailing Address - Phone:520-459-3012
Mailing Address - Fax:520-515-8663
Practice Address - Street 1:815 E 15TH ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:AZ
Practice Address - Zip Code:85607-1631
Practice Address - Country:US
Practice Address - Phone:520-364-5437
Practice Address - Fax:520-805-2986
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ50104208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ012819Medicaid