Provider Demographics
NPI:1497897383
Name:PATTERSON, TONY
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 OWL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:TN
Mailing Address - Zip Code:37306-2602
Mailing Address - Country:US
Mailing Address - Phone:931-967-0323
Mailing Address - Fax:
Practice Address - Street 1:115 DYER ST STE 1
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4551
Practice Address - Country:US
Practice Address - Phone:931-560-4220
Practice Address - Fax:931-560-4221
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health