Basic Information
Provider Information
NPI: 1871973172
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COURTRIGHT
FirstName: PATRICK
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 245 N 15TH ST
Address2: 6TH FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191021101
CountryCode: US
TelephoneNumber: 2157627916
FaxNumber: 2157627765
Practice Location
Address1: 245 N 15TH ST
Address2: 6TH FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191021101
CountryCode: US
TelephoneNumber: 2157627916
FaxNumber: 2157627765
Other Information
ProviderEnumerationDate: 06/02/2015
LastUpdateDate: 04/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMT208661PAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207L00000X282415MAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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