Provider Demographics
NPI:1417015694
Name:PATTON, DARLENE MCDONALD (DPH)
Entity Type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:MCDONALD
Last Name:PATTON
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 W FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-3902
Mailing Address - Country:US
Mailing Address - Phone:731-422-0232
Mailing Address - Fax:731-422-0389
Practice Address - Street 1:62 WEATHERIDGE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-9782
Practice Address - Country:US
Practice Address - Phone:731-664-4804
Practice Address - Fax:731-422-0389
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist