Healthcare Provider Details

I. General information

NPI: 1184251209
Provider Name (Legal Business Name): AKRUTI PATEL PRABHAKAR DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AKRUTI GIRISH PATEL DO

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E CHESTNUT ST BLDG SUITE303
LOUISVILLE KY
40202-1831
US

IV. Provider business mailing address

128 E APPLE ST FL 2
DAYTON OH
45409-2902
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-5552
  • Fax: 502-629-3132
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34.016242
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number06233
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: