Healthcare Provider Details

I. General information

NPI: 1790732113
Provider Name (Legal Business Name): JIGNESH NIRANJAN PATEL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 01/25/2022
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5141 W BROAD ST STE 150
COLUMBUS OH
43228-1984
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 614-544-1401
  • Fax: 614-544-1403
Mailing address:
  • Phone: 614-533-6497
  • Fax: 614-544-1403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5101015105
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: