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General NPI Number Information
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NPI Number | 1164569570
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Entity Type | Organization
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Legal Business Name | JEMISON INTERNAL MEDICINE PC
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 24548 US HWY 31
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City | JEMISON
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State | AL
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Zip | 35085
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Country | US
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Telephone | 205-688-4050
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Fax | 205-688-3207
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Provider Business Mailing Address
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Address Line | PO BOX 669 24548 US HWY 31
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City | JEMISON
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State | AL
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Zip | 35085
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Country | US
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Telephone | 205-688-4050
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Fax | 205-688-3207
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAY PRAKASH D PATEL
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Credential | MD
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Telephone | 205-688-4050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 17742
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License Number State | AL
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