Healthcare Provider Details

I. General information

NPI: 1821770934
Provider Name (Legal Business Name): ASHUTOSH PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E 5TH AVE
WINFIELD KS
67156-2407
US

IV. Provider business mailing address

801 E DOUGLAS AVE STE 233
WICHITA KS
67202-3548
US

V. Phone/Fax

Practice location:
  • Phone: 620-221-2300
  • Fax:
Mailing address:
  • Phone: 800-924-8140
  • Fax: 414-955-6409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number85989-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: