Healthcare Provider Details

I. General information

NPI: 1023301041
Provider Name (Legal Business Name): ARVIND PATEL, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2011
Last Update Date: 09/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CENTER ST STE 501
COLUMBUS GA
31901-1554
US

IV. Provider business mailing address

700 CENTER ST STE 501
COLUMBUS GA
31901-1554
US

V. Phone/Fax

Practice location:
  • Phone: 706-653-1152
  • Fax:
Mailing address:
  • Phone: 706-653-1152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number037886
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number062002
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number062002
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number037886
License Number StateGA

VIII. Authorized Official

Name: ARVIND PATEL
Title or Position: OWNER
Credential: MD
Phone: 706-653-1152