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General NPI Number Information
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NPI Number | 1497841548
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Entity Type | Organization
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Legal Business Name | GILLETTE INTERNAL MEDICINE ASSOCIATES PC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 407 S MEDICAL ARTS CT SUITE D
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City | GILLETTE
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State | WY
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Zip | 82716-3372
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Country | US
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Telephone | 307-682-0400
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Fax | 307-686-7420
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Provider Business Mailing Address
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Address Line | 407 S MEDICAL ARTS CT SUITE D
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City | GILLETTE
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State | WY
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Zip | 82716-3372
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Country | US
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Telephone | 307-682-0400
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Fax | 307-686-7420
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIRTIKUMAR L PATEL
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Credential | MD
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Telephone | 307-682-0400
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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 |
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License Number State |
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