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General NPI Number Information
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NPI Number | 1689758807
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Entity Type | Organization
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Legal Business Name | JITENDRA K. PATEL M.D. INC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 723 8TH ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-4265
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Country | US
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Telephone | 740-353-5306
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Fax | 740-353-8131
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Provider Business Mailing Address
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Address Line | 723 8TH ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-4265
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Country | US
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Telephone | 740-353-5306
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Fax | 740-353-8131
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JITENDRA K PATEL
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Credential | M.D
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Telephone | 740-353-5306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35069645P
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License Number State | OH
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