Provider Demographics
NPI:1821347097
Name:PATTON, ROBERT WILLIAM JR (MD, JD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:PATTON
Suffix:JR
Gender:M
Credentials:MD, JD
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 1173
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34697-1173
Mailing Address - Country:US
Mailing Address - Phone:727-478-0355
Mailing Address - Fax:727-470-2004
Practice Address - Street 1:1121 OVERCASH DR
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-5516
Practice Address - Country:US
Practice Address - Phone:727-478-0355
Practice Address - Fax:727-213-6954
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0049564207RN0300X
GA32450207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD60966Medicare UPIN