Provider Demographics
NPI:1457617516
Name:PATTON, MARQUAND JR (DO)
Entity Type:Individual
Prefix:
First Name:MARQUAND
Middle Name:
Last Name:PATTON
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6233 W BEHREND DR
Mailing Address - Street 2:2034
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6970
Mailing Address - Country:US
Mailing Address - Phone:480-652-1695
Mailing Address - Fax:
Practice Address - Street 1:2601 SW 37TH AVE STE 901
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2751
Practice Address - Country:US
Practice Address - Phone:305-285-7282
Practice Address - Fax:305-285-7114
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019400207RC0000X
390200000X
FLOS12388207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program