Provider Demographics
NPI:1720027089
Name:PATTON, RITA
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:PATTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1717 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1801
Practice Address - Country:US
Practice Address - Phone:800-822-8816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL41862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051522713PATOtherFED BC
AL051545220OtherBCBS
AL051547292OtherBCBS
AL100245Medicaid
AL009912714Medicaid
AL051047145PATOtherBCBS
AL051545217OtherBCBS
AL123024Medicaid
AL009912717Medicaid
AL051598086OtherBCBS
AL009912712Medicaid
AL110083Medicaid
AL51110160OtherBCBS
ALP00468883OtherRAILROAD MEDICARE
ALPA009969260Medicaid
MS08534255Medicaid
AL051591498OtherBCBS
AL051545218OtherBCBS
AL102845Medicaid
AL051545219OtherBCBS
AL102845Medicaid
AL051545220OtherBCBS
AL009912714Medicaid