Provider Demographics
NPI:1376585166
Name:PATTERSON SCHLOTTERER MEDICAL GROUP
Entity Type:Organization
Organization Name:PATTERSON SCHLOTTERER MEDICAL GROUP
Other - Org Name:PS MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHLOTTERER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-257-9229
Mailing Address - Street 1:515 W BUCKEYE RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-2647
Mailing Address - Country:US
Mailing Address - Phone:602-257-9229
Mailing Address - Fax:602-257-9368
Practice Address - Street 1:515 W BUCKEYE RD
Practice Address - Street 2:SUITE 402
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-2647
Practice Address - Country:US
Practice Address - Phone:480-759-1040
Practice Address - Fax:480-759-3520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty