Provider Demographics
NPI:1316409519
Name:PATEL, CHIRAG MUKESH
Entity Type:Individual
Prefix:DR
First Name:CHIRAG
Middle Name:MUKESH
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:CHIRAG
Other - Middle Name:M
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10030 WILLOW BROOK CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5354
Mailing Address - Country:US
Mailing Address - Phone:267-764-6144
Mailing Address - Fax:
Practice Address - Street 1:1169 EASTERN PKWY STE 3440
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1421
Practice Address - Country:US
Practice Address - Phone:432-978-5929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY267218213EP1101X, 213ES0000X, 213ES0103X, 213E00000X
PASC007062213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery