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General NPI Number Information
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NPI Number | 1740279009
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Entity Type | Individual
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Provider Name | JAY U PATEL MD
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Gender | Male
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 2929 LAKE PARK DR
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City | LAKE SPIVEY
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State | GA
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Zip | 30236-4131
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Country | US
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Telephone | 773-726-2682
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 415250
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City | BOSTON
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State | MA
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Zip | 02241-5250
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Country | US
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Telephone | 610-644-8900
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Fax | 484-924-0053
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01058826
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 079216
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License Number State | GA
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