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General NPI Number Information
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NPI Number | 1962787572
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Entity Type | Organization
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Legal Business Name | SHARAD PATEL LLC
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Dates
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Enumeration Date | 10/14/2011
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Last Update Date | 09/26/2012
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Provider Practice Location Address
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Address Line | 1230 WOODLAND DR STE 210
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2792
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Country | US
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Telephone | 270-300-2468
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Fax | 270-360-1619
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Provider Business Mailing Address
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Address Line | 1230 WOODLAND DR STE 210
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2792
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Country | US
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Telephone | 270-300-2468
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Fax | 270-360-1619
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | SHARAD PATEL
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Credential | M.D.
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Telephone | 270-300-2468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 20851
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License Number State | KY
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