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General NPI Number Information
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NPI Number | 1932192911
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Entity Type | Individual
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Provider Name | DEODUTT PATEL MD
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Gender | Male
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 90 JACKSON PIKE
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City | GALLIPOLIS
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State | OH
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Zip | 45631-1560
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Country | US
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Telephone | 740-446-5289
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Fax | 740-446-5697
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Provider Business Mailing Address
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Address Line | 90 JACKSON PIKE
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City | GALLIPOLIS
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State | OH
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Zip | 45631-1560
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Country | US
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Telephone | 740-441-1949
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Fax | 740-446-5982
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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 | 35052140
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License Number State | OH
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