Provider Demographics
NPI:1952864266
Name:PATTON, ROY C
Entity Type:Individual
Prefix:MS
First Name:ROY
Middle Name:C
Last Name:PATTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 CLINTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-5217
Mailing Address - Country:US
Mailing Address - Phone:989-798-6578
Mailing Address - Fax:
Practice Address - Street 1:305 CLINTON BLVD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5217
Practice Address - Country:US
Practice Address - Phone:989-798-6578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies