Provider Demographics
NPI:1427213842
Name:PATEL, HARSHUL AMRUT (MD)
Entity Type:Individual
Prefix:DR
First Name:HARSHUL
Middle Name:AMRUT
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 KENTON ST STE 1D
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-1981
Mailing Address - Country:US
Mailing Address - Phone:270-887-9066
Mailing Address - Fax:
Practice Address - Street 1:1724 KENTON ST STE 1D
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1981
Practice Address - Country:US
Practice Address - Phone:270-887-9066
Practice Address - Fax:270-887-9199
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02886000183500000X
KY42143207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000577212OtherANTHEM BCBS
KY7100050080Medicaid
KY000000577212OtherANTHEM BCBS
KY00280082Medicare PIN