Provider Demographics
NPI:1437145497
Name:PATTERSON, MARK D (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:PATTERSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1410 TUSCULUM BLVD
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4286
Mailing Address - Country:US
Mailing Address - Phone:423-787-7100
Mailing Address - Fax:423-787-7109
Practice Address - Street 1:1410 TUSCULUM BLVD
Practice Address - Street 2:SUITE 1700
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4286
Practice Address - Country:US
Practice Address - Phone:423-787-7100
Practice Address - Fax:423-787-7109
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2017-02-21
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000023899208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3090534Medicaid
TNG01515Medicare UPIN
3090534Medicare PIN
TN3090534Medicaid