Provider Demographics
NPI:1487702726
Name:PATTERSON, JAMES KENDRICK (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KENDRICK
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2671 APPLING RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38133-5001
Mailing Address - Country:US
Mailing Address - Phone:901-213-0505
Mailing Address - Fax:901-213-0957
Practice Address - Street 1:2671 APPLING RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38133-5001
Practice Address - Country:US
Practice Address - Phone:901-213-0505
Practice Address - Fax:901-213-0957
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD017223174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMD017223OtherSTATE LICENSE
TNMD017223OtherSTATE LICENSE
TNBP0507256OtherDEA