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NPI Code Detail

MEDICARE: KINAL KIM PATEL D.O.

MEDICARE:   KINAL KIM PATEL  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician5101022711MI
2207R00000XInternal Medicine Physician33724NH

General Provider Information

NPI Number : 1063862480
Entity Type Code : Individual
Provider Name (Legal Business Name) : KINAL KIM PATEL D.O.
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2001 N 4TH ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-4227
Country : US
Telephone Number : 928-527-4325
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2016
Last Update Date : 12/15/2025

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Directions to “ KINAL KIM PATEL D.O.” Practice Location

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