Provider Demographics
NPI:1649704065
Name:BILTMORE DERMATOLOGY LLC
Entity type:Organization
Organization Name:BILTMORE DERMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DCNP
Authorized Official - Phone:812-994-1404
Mailing Address - Street 1:PO BOX 3445
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-3445
Mailing Address - Country:US
Mailing Address - Phone:812-994-1404
Mailing Address - Fax:844-262-4878
Practice Address - Street 1:76 W SPRINGHILL DR
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-8767
Practice Address - Country:US
Practice Address - Phone:812-994-1404
Practice Address - Fax:844-262-4878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-12
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty