Provider Demographics
NPI:1508897018
Name:PATTERSON, JARED JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:JAMES
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3334 CAPITAL MEDICAL BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4470
Mailing Address - Country:US
Mailing Address - Phone:850-877-8174
Mailing Address - Fax:844-261-6839
Practice Address - Street 1:2011 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4545
Practice Address - Country:US
Practice Address - Phone:850-691-4188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162818207XS0114X, 207X00000X, 207XS0114X
TN42271207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQUCX5OtherBCBSFL
TN41535OtherTLC
TN620819926OtherAETNA
MS06535209Medicaid
TN3447891OtherCIGNA
MS620819926OtherBCBS
TN620819926OtherTRICARE
TN620819926OtherCIGNA
TN7218901OtherAETNA
TN30000102Medicaid
TN4154727OtherBCBS
TNP00420649OtherRAILROAD MEDICARE
MS7187860Medicaid
TN3371161Medicaid
TN41535OtherTLC
TN3371161Medicaid
TN30000102Medicaid