Provider Demographics
NPI:1770273799
Name:PATTERSON, JULIA (DO)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 BLUEBIRD AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-3907
Mailing Address - Country:US
Mailing Address - Phone:229-854-5129
Mailing Address - Fax:
Practice Address - Street 1:1405 BLUEBIRD AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-3907
Practice Address - Country:US
Practice Address - Phone:229-854-5129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program