Provider Demographics
NPI:1548475189
Name:PATTERSON, CONNOR A (MD)
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:A
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 1:1985 JEFFERSON DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-6233
Mailing Address - Country:US
Mailing Address - Phone:225-766-5151
Mailing Address - Fax:225-766-8216
Practice Address - Street 1:1985 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-6233
Practice Address - Country:US
Practice Address - Phone:540-373-6647
Practice Address - Fax:540-479-1656
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2019-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.203711207NS0135X, 207N00000X
VA0101267201207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology