Provider Demographics
NPI:1972123222
Name:PATTERSON, AUSTIN M (DO)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:M
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 WAYNE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-3300
Mailing Address - Country:US
Mailing Address - Phone:740-374-6030
Mailing Address - Fax:740-374-6029
Practice Address - Street 1:802 WAYNE ST STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3300
Practice Address - Country:US
Practice Address - Phone:740-374-6030
Practice Address - Fax:740-374-6029
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4299207QS0010X
OH34.017469207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine