Healthcare Provider Details

I. General information

NPI: 1710121975
Provider Name (Legal Business Name): RUSHA JAYESH PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2009
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NE 10TH ST # 4C
OKLAHOMA CITY OK
73104-5417
US

IV. Provider business mailing address

PO BOX 9200
MORGANTOWN WV
26506-9200
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-1368
  • Fax: 405-271-3248
Mailing address:
  • Phone: 304-598-4825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number37778
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number26753
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number37158
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: