Provider Demographics
NPI:1871990473
Name:ROBERT W PATTON JR MD JD PA
Entity type:Organization
Organization Name:ROBERT W PATTON JR MD JD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD JD
Authorized Official - Phone:727-478-0355
Mailing Address - Street 1:613 S MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-5615
Mailing Address - Country:US
Mailing Address - Phone:727-478-0355
Mailing Address - Fax:727-470-2004
Practice Address - Street 1:613 S MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5615
Practice Address - Country:US
Practice Address - Phone:727-478-0355
Practice Address - Fax:727-470-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME49564207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty