Provider Demographics
NPI:1669577938
Name:PATTEN, JOHN L (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:L
Last Name:PATTEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT
Mailing Address - Street 2:PO BOX 7291
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-7291
Mailing Address - Country:US
Mailing Address - Phone:207-777-8941
Mailing Address - Fax:207-777-8800
Practice Address - Street 1:21 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:ME
Practice Address - Zip Code:04444
Practice Address - Country:US
Practice Address - Phone:207-862-0300
Practice Address - Fax:207-907-1041
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2022-02-03
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Provider Licenses
StateLicense IDTaxonomies
ME1654207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME266530099Medicaid
ME266530099Medicaid
H14339Medicare UPIN