Provider Demographics
NPI:1518959998
Name:TATE, PATRICIA REED (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:REED
Last Name:TATE
Suffix:
Gender:F
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:PO BOX 950165
Mailing Address - Street 2:DEPT 53069
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0165
Mailing Address - Country:US
Mailing Address - Phone:812-945-3916
Mailing Address - Fax:812-944-3404
Practice Address - Street 1:911 N SHELBY ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IN
Practice Address - Zip Code:47167-2304
Practice Address - Country:US
Practice Address - Phone:812-883-5881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01025438A207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000062193OtherANTHEM BENEFIT
IN000000062193OtherONE NATION BENEFIT
IN000000062193OtherINDIANA HEALTH
IN000000062193OtherANTHEM SENIOR ADVANTAGE
IN000000062193OtherANTHEM
KY000000062193OtherANTHEM
IN000000062193OtherUNICARE
IN000000062193OtherINDIANA COMPREHENSIVE
IN241950OtherUNICARE MEDICARE
IN000000062193OtherANTHEM BENEFIT
IN000000062193OtherINDIANA COMPREHENSIVE