Provider Demographics
NPI:1356310627
Name:PATTERSON, ANN B (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:B
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:721 W 13TH ST
Mailing Address - Street 2:SUITE 322
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-1855
Mailing Address - Country:US
Mailing Address - Phone:812-634-6646
Mailing Address - Fax:812-634-7625
Practice Address - Street 1:721 W 13TH ST
Practice Address - Street 2:SUITE 322
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-1855
Practice Address - Country:US
Practice Address - Phone:812-634-6646
Practice Address - Fax:812-634-7625
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01047312207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G96816Medicare UPIN
IN149650BMedicare ID - Type Unspecified