Provider Demographics
NPI:1295844355
Name:HIREN K PATEL MD PC
Entity Type:Organization
Organization Name:HIREN K PATEL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HIREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-745-3534
Mailing Address - Street 1:1941 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5403
Mailing Address - Country:US
Mailing Address - Phone:334-745-3534
Mailing Address - Fax:334-745-3535
Practice Address - Street 1:1941 1ST AVE
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5403
Practice Address - Country:US
Practice Address - Phone:334-745-3534
Practice Address - Fax:334-745-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20098207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009962140Medicaid
AL051502860Medicare ID - Type Unspecified
AL009962140Medicaid