Healthcare Provider Details

I. General information

NPI: 1235205014
Provider Name (Legal Business Name): PRATAPSINH GOHIL D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2006
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 CORWIN LN
KOKOMO IN
46902-6612
US

IV. Provider business mailing address

PO BOX 3098
KOKOMO IN
46904-3098
US

V. Phone/Fax

Practice location:
  • Phone: 765-453-7788
  • Fax: 765-453-5828
Mailing address:
  • Phone: 765-453-7788
  • Fax: 765-453-5828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number07000473
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: