Provider Demographics
NPI:1982747416
Name:PATTISON, JEFF A (RPH)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:A
Last Name:PATTISON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CONCORD
Mailing Address - State:OH
Mailing Address - Zip Code:43762-1286
Mailing Address - Country:US
Mailing Address - Phone:740-826-4000
Mailing Address - Fax:
Practice Address - Street 1:10 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CONCORD
Practice Address - State:OH
Practice Address - Zip Code:43762-1286
Practice Address - Country:US
Practice Address - Phone:740-826-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-22008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist