Provider Demographics
NPI:1346600939
Name:PAIR, PATRICK TYLER (PA-C)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:TYLER
Last Name:PAIR
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:7112 S COPPERFIELD CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3504
Mailing Address - Country:US
Mailing Address - Phone:334-462-1943
Mailing Address - Fax:
Practice Address - Street 1:440 TAYLOR RD STE 3380
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3587
Practice Address - Country:US
Practice Address - Phone:334-213-6255
Practice Address - Fax:334-213-6243
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant