Provider Demographics
NPI:1841285368
Name:PATTON, ALLEN J (MD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:J
Last Name:PATTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1717 N E ST
Mailing Address - Street 2:SUITE 231
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-6396
Mailing Address - Country:US
Mailing Address - Phone:850-444-4717
Mailing Address - Fax:850-434-2647
Practice Address - Street 1:1717 N E ST
Practice Address - Street 2:SUITE 231
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-6396
Practice Address - Country:US
Practice Address - Phone:850-444-4785
Practice Address - Fax:850-434-2647
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL0021360207RH0003X
AL8124207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000020683Medicaid
FL059593400Medicaid
AL051552188PATMedicare ID - Type UnspecifiedAL MEDICARE INDIVIDUAL #
FL059593400Medicaid
FL17393ZMedicare ID - Type Unspecified