MEDICARE: DR. ATULKUMAR RAMANBHAI PATEL MD

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	207R00000X	Internal Medicine Physician	J3721	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J3721	OTHER	TX	LICENCE

General Provider Information

NPI Number	:	1447255252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ATULKUMAR RAMANBHAI PATEL MD

Provider Business Mailing Address
First Line	:	2019 S HENDERSON BLVD, STE 2A
Second Line	:	STE 2A
City	:	KILGORE
State	:	TX
Zip	:	75662-3672
Country	:	US
Telephone Number	:	903-984-2002
Fax Number	:

Provider Business Practice Location Address
First Line	:	2019 S HENDERSON BLVD
Second Line	:	STE 2A
City	:	KILGORE
State	:	TX
Zip	:	75662-3672
Country	:	US
Telephone Number	:	903-984-2002
Fax Number	:

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	03/07/2023

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