Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | L05690R | LA |
N | 207RP1001X | Pulmonary Disease | L05690R | LA |
NPI | 1477512309 |
---|---|
Provider Name | Dr. Kirit S Patel |
First Address | Shreveport, LA 71118-3351 |
Second Address | Shreveport, LA 71118-3351 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 09/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1322954 | (05) | LA |
B89737 | (02) | LA |