Provider Demographics
NPI:1689834145
Name:PATZKOWSKI, JEANNE CAMERON (MD)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:CAMERON
Last Name:PATZKOWSKI
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3851 ROGER BROOKE DR
Mailing Address - Street 2:MCHE-QD (CREDS)
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4501
Mailing Address - Country:US
Mailing Address - Phone:210-916-1242
Mailing Address - Fax:210-916-5102
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:MCHE-QD (CREDS)
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-1242
Practice Address - Fax:210-916-5102
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2020-05-13
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Provider Licenses
StateLicense IDTaxonomies
VA0101246388207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine