Provider Demographics
NPI:1780111047
Name:PATTON, SEAN
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:PATTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 N BUSINESS DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5204
Mailing Address - Country:US
Mailing Address - Phone:479-973-7155
Mailing Address - Fax:479-582-0778
Practice Address - Street 1:3715 N BUSINESS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5204
Practice Address - Country:US
Practice Address - Phone:479-973-7155
Practice Address - Fax:479-582-0778
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator