Provider Demographics
NPI:1609879865
Name:FLYNN, PATRICIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:M
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:ST. JUDE CHILDREN'S RESEARCH HOSPITAL
Mailing Address - Street 2:332 N LAUDERDALE ST., MS 0515
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-2794
Mailing Address - Country:US
Mailing Address - Phone:901-495-3006
Mailing Address - Fax:901-495-3842
Practice Address - Street 1:ST. JUDE CHILDREN'S RESEARCH HOSPITAL
Practice Address - Street 2:332 N LAUDERDALE ST., MS 0515
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-2794
Practice Address - Country:US
Practice Address - Phone:901-495-3006
Practice Address - Fax:901-495-3842
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-23
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN155572080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00015183Medicaid
OH2004422Medicaid
KY64795750Medicaid
VA6738338Medicaid
TN3029895Medicaid
LA1429651Medicaid
IA0533356Medicaid
LA1429651Medicaid
MS00015183Medicaid