Provider Demographics
NPI:1477622504
Name:PATIL, JAMNADAS R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMNADAS
Middle Name:R
Last Name:PATIL
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 1:500 STATE HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:OSAWATOMIE
Mailing Address - State:KS
Mailing Address - Zip Code:66064-1813
Mailing Address - Country:US
Mailing Address - Phone:913-755-7000
Mailing Address - Fax:913-755-7127
Practice Address - Street 1:500 STATE HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:OSAWATOMIE
Practice Address - State:KS
Practice Address - Zip Code:66064-1813
Practice Address - Country:US
Practice Address - Phone:913-755-7000
Practice Address - Fax:913-755-7127
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS08002632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSH95117Medicare UPIN
KS103306Medicare ID - Type UnspecifiedMEDICARE B PROVIDER #