Provider Demographics
NPI:1568293637
Name:PATTERSON, RAYMOND ALLEN (PHARMD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:ALLEN
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 PEYTON DR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-5479
Mailing Address - Country:US
Mailing Address - Phone:404-386-2455
Mailing Address - Fax:
Practice Address - Street 1:1199 PEYTON DR NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-5479
Practice Address - Country:US
Practice Address - Phone:404-386-2455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0337531835E0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835E0208XPharmacy Service ProvidersPharmacistEmergency Medicine