Provider Demographics
NPI:1538751003
Name:PATTON, SIDNEY SANDERS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:SANDERS
Last Name:PATTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SIDNEY
Other - Middle Name:ELIZABETH
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:279 N BROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-2589
Mailing Address - Country:US
Mailing Address - Phone:770-867-9081
Mailing Address - Fax:770-867-8229
Practice Address - Street 1:279 N BROAD ST STE A
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-2589
Practice Address - Country:US
Practice Address - Phone:770-867-9081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist