Provider Demographics
NPI:1265411672
Name:WOLFE, PATRICIA ANNE (DO)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANNE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:ANNE
Other - Last Name:TIMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1810 MULKEY RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1151
Mailing Address - Country:US
Mailing Address - Phone:770-819-9262
Mailing Address - Fax:678-945-1295
Practice Address - Street 1:1810 MULKEY RD
Practice Address - Street 2:SUITE 201
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1151
Practice Address - Country:US
Practice Address - Phone:770-819-9262
Practice Address - Fax:678-945-1295
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059238208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H29377OtherHEALTH ASSURANCE INS CO
121723OtherMERCY HEALTH PLAN
PA0018005820002Medicaid
PA000000120048OtherUNISON HEALTH PLAN OF PA
1769933OtherGREAT WEST HEALTHCARE
01114001OtherCAPITAL BLUE CROSS
160754OtherHIGHMARK BLUE SHIELD
4500377OtherAETNA INSURANCE COMPANY
4500377OtherAETNA INSURANCE COMPANY
121723OtherMERCY HEALTH PLAN