Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | GA-011358 | GA |
Y | 213EG0000X | General Practice | GA-011358 | GA |
NPI | 1003088576 |
---|---|
Provider Name | Dr. Jigisha K Patel |
First Address | Douglasville, GA 30134-5621 |
Second Address | Douglasville, GA 30134-5621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2008 |
Last Update Date | 25/03/2008 |