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General NPI Number Information
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NPI Number | 1760666010
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Entity Type | Organization
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Legal Business Name | J. M. PATIL, M. D., P. A.
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 10/14/2008
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Provider Practice Location Address
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Address Line | 603 HIGHWAY 418 W STE #1
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City | SILSBEE
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State | TX
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Zip | 77656-3660
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Country | US
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Telephone | 409-385-9497
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Fax | 409-385-9464
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Provider Business Mailing Address
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Address Line | PO BOX 2246
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City | SILSBEE
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State | TX
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Zip | 77656-2246
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Country | US
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Telephone | 409-385-9497
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Fax | 409-385-9464
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAIRAJ M. PATIL
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Credential | M.D.
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Telephone | 409-385-9497
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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 | G4675
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License Number State | TX
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