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General NPI Number Information
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NPI Number | 1013998004
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Entity Type | Individual
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Provider Name | RAKESHKUMAR PATEL M.D., MBA
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Gender | Male
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 1025 EXECUTIVE PARK BLVD
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City | KINGSPORT
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State | TN
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Zip | 37660-4620
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Country | US
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Telephone | 423-830-8110
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Fax | 423-473-1102
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Provider Business Mailing Address
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Address Line | 805 QUAIL RIDGE CT
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City | ELIZABETHTON
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State | TN
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Zip | 37643-5064
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101238677
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD41317
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD41317
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License Number State | TN
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