Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN122312 | GA |
Y | 213EG0000X | General Practice | DN122312 | GA |
NPI | 1003488172 |
---|---|
Provider Name | Dr. Bhakti Bharat Patel |
First Address | Macon, GA 31201-1495 |
Second Address | Macon, GA 31210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2021 |
Last Update Date | 16/07/2021 |