Provider Demographics
NPI:1780294124
Name:PATTERSON, EUGENE
Entity type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:
Last Name:PATTERSON
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 1:155 PEACEFUL LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35146-5538
Mailing Address - Country:US
Mailing Address - Phone:205-895-9129
Mailing Address - Fax:205-629-7041
Practice Address - Street 1:1495 CENTER POINT PKWY STE B
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:AL
Practice Address - Zip Code:35215-6141
Practice Address - Country:US
Practice Address - Phone:205-895-9129
Practice Address - Fax:205-629-7041
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTA6697225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty