MEDICARE: JAYANTIBHAI PATEL M.D.

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
1	174400000X	Specialist	28930	AZ
2	2084N0400X	Neurology Physician	28930	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1Z0871	OTHER	AZ	HEALTHNET ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	5085187	OTHER	AZ	AETNA INSURANCE
4	AZ0881440	OTHER	AZ	BCBS PROVIDER ID

General Provider Information

NPI Number	:	1366444341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYANTIBHAI PATEL M.D.

Provider Business Mailing Address
First Line	:	2979 W ELLIOT RD
Second Line	:	SUITE 2
City	:	CHANDLER
State	:	AZ
Zip	:	85224-1641
Country	:	US
Telephone Number	:	480-615-7800
Fax Number	:	480-615-7803

Provider Business Practice Location Address
First Line	:	2979 W ELLIOT RD
Second Line	:	SUITE 2
City	:	CHANDLER
State	:	AZ
Zip	:	85224-1641
Country	:	US
Telephone Number	:	480-615-7800
Fax Number	:	480-615-7803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	05/01/2013

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Directions to “ JAYANTIBHAI PATEL M.D.” Practice Location

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