MEDICARE: RAVI D PATEL

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	208M00000X	Hospitalist Physician	34000	OK

General Provider Information

NPI Number	:	1558744037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAVI D PATEL

Provider Business Mailing Address
First Line	:	300 SW 167TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73170-6708
Country	:	US
Telephone Number	:	216-246-6160
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 NW EXPRESSWAY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4999
Country	:	US
Telephone Number	:	405-949-3011
Fax Number	:

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

Provider Enumeration Date	:	07/02/2015
Last Update Date	:	04/11/2022

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Directions to “ RAVI D PATEL ” Practice Location

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