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General NPI Number Information
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NPI Number | 1962433599
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Entity Type | Individual
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Provider Name | JAYMAL R PATEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 3131 S MAIN ST
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City | MOULTRIE
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State | GA
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Zip | 31768-6925
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Country | US
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Telephone | 229-891-9443
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2876
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City | MOULTRIE
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State | GA
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Zip | 31776-2876
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Country | US
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Telephone | 229-891-9443
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 050984
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License Number State | GA
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