Provider Demographics
NPI:1578824967
Name:PATRICK, KATHRYN ELEANOR (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ELEANOR
Last Name:PATRICK
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 1:6440 W NEWBERRY RD STE 507
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-8302
Mailing Address - Country:US
Mailing Address - Phone:352-224-1840
Mailing Address - Fax:
Practice Address - Street 1:6440 W NEWBERRY RD STE 507
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-8302
Practice Address - Country:US
Practice Address - Phone:352-224-1840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-03
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN17257207V00000X
FLME 128805207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology