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General NPI Number Information
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NPI Number | 1093758187
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Entity Type | Individual
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Provider Name | ASHISH VIJAY PATEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 08/07/2020
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Provider Practice Location Address
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Address Line | 269 CUSICK RD STE A
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City | ALCOA
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State | TN
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Zip | 37701-3192
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Country | US
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Telephone | 865-888-6923
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Fax |
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Provider Business Mailing Address
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Address Line | 12236 PATAGONIA LN
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City | KNOXVILLE
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State | TN
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Zip | 37922-1909
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Country | US
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Telephone | 423-943-3001
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 4301109047
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 39013
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License Number State | TN
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