Healthcare Provider Details

I. General information

NPI: 1124302724
Provider Name (Legal Business Name): DR. MITUL PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2011
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 TOWNE BLVD
MIDDLETOWN OH
45044-6200
US

IV. Provider business mailing address

7332 W OBSERVATORY
WEST CHESTER OH
45069-5311
US

V. Phone/Fax

Practice location:
  • Phone: 512-423-4882
  • Fax:
Mailing address:
  • Phone: 502-424-7082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number015639
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03438475
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: