Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 42990 | KY |
NPI | 1073783031 |
---|---|
Provider Name | Dr. Amit B Patel |
First Address | Lexington, KY 40536-0284 |
Second Address | Lexington, KY 40536-0293 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2008 |
Last Update Date | 12/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01064592A | STATE MEDICAL LICENSE (01) | IN |
01064592B | STATE CSR (01) | IN |