Provider Demographics
NPI:1306926365
Name:PATTERSON, MICHAEL L (BS, DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 3RD ST NE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-2053
Mailing Address - Country:US
Mailing Address - Phone:256-734-5050
Mailing Address - Fax:256-734-5051
Practice Address - Street 1:1613 3RD ST NE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-2053
Practice Address - Country:US
Practice Address - Phone:256-734-5050
Practice Address - Fax:256-734-5051
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1075111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-70850OtherBLUE CROSS
AL510-70850OtherBLUE CROSS
AL000070850Medicare ID - Type Unspecified