Provider Demographics
NPI:1447379482
Name:PATEL, NAVIN
Entity Type:Individual
Prefix:MR
First Name:NAVIN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6900
Mailing Address - Country:US
Mailing Address - Phone:706-202-7288
Mailing Address - Fax:
Practice Address - Street 1:1305 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-2879
Practice Address - Country:US
Practice Address - Phone:706-367-8828
Practice Address - Fax:706-367-5562
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017282183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist