Provider Demographics
NPI:1346648748
Name:ANAYA PATEL LLC
Entity Type:Organization
Organization Name:ANAYA PATEL LLC
Other - Org Name:CHIROCARE CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAMEEL
Authorized Official - Middle Name:SUBHASH
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-751-9055
Mailing Address - Street 1:327 E JACKSON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-5194
Mailing Address - Country:US
Mailing Address - Phone:229-227-0026
Mailing Address - Fax:229-227-1523
Practice Address - Street 1:327 E JACKSON ST
Practice Address - Street 2:SUITE B
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-5194
Practice Address - Country:US
Practice Address - Phone:229-227-0026
Practice Address - Fax:229-227-1523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008903111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I359715OtherMEDICARE PTAN