Provider Demographics
NPI:1811942287
Name:A.J. PATTERSON, M.D., ASSOC
Entity type:Organization
Organization Name:A.J. PATTERSON, M.D., ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:724-627-5474
Mailing Address - Street 1:112 WALNUT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-1668
Mailing Address - Country:US
Mailing Address - Phone:724-627-5474
Mailing Address - Fax:
Practice Address - Street 1:112 WALNUT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-1668
Practice Address - Country:US
Practice Address - Phone:724-627-5474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000912978004Medicaid
PA431081Medicare ID - Type Unspecified