MEDICARE: PARU PATEL AG-ACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN324579	GA
2	363L00000X	Nurse Practitioner	4026905	KY

General Provider Information

NPI Number	:	1467235549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARU PATEL AG-ACNP

Provider Business Mailing Address
First Line	:	777 HEMLOCK ST
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31201-2102
Country	:	US
Telephone Number	:	478-633-6272
Fax Number	:	478-633-6272

Provider Business Practice Location Address
First Line	:	777 HEMLOCK ST
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31201-2102
Country	:	US
Telephone Number	:	478-633-6272
Fax Number	:	478-633-6272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2023
Last Update Date	:	04/13/2026

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Directions to “ PARU PATEL AG-ACNP” Practice Location

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