Provider Demographics
NPI:1548728413
Name:PATTERSON, JOEL NATHANEAL (PHARMD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:NATHANEAL
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 1:410 CLUB PARK DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MS
Mailing Address - Zip Code:39730-2254
Mailing Address - Country:US
Mailing Address - Phone:662-322-8262
Mailing Address - Fax:
Practice Address - Street 1:314 HIGHWAY 145 N
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-2310
Practice Address - Country:US
Practice Address - Phone:662-369-7775
Practice Address - Fax:662-369-7753
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist