Provider Demographics
NPI:1306891015
Name:PATTERSON, PATRICK AUSTIN (OD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:AUSTIN
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CAMPEN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-1500
Mailing Address - Country:US
Mailing Address - Phone:252-838-8822
Mailing Address - Fax:252-838-0013
Practice Address - Street 1:300 CAMPEN RD
Practice Address - Street 2:SUITE A
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516-1500
Practice Address - Country:US
Practice Address - Phone:252-838-8822
Practice Address - Fax:252-838-0013
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1505152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0907BOtherBCBSNC
NC890915GMedicaid
NC2468648EMedicare PIN
NCU44959Medicare UPIN
NC3914090001Medicare NSC