Provider Demographics
NPI:1225019490
Name:PATTERSON, ARTHUR JAMES JR (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:JAMES
Last Name:PATTERSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ARTHUR
Other - Middle Name:JAMES
Other - Last Name:PATTERSON
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:108 PARKVIEW DR
Mailing Address - Street 2:APT# 104
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-4557
Mailing Address - Country:US
Mailing Address - Phone:724-998-2473
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-4199
Practice Address - Country:US
Practice Address - Phone:304-623-3461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022347E174400000X
WV25765208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009129870003Medicaid
PA0009129870003Medicaid
PAD71448Medicare UPIN