Provider Demographics
NPI:1548385966
Name:PATEL, JAYESH (MD)
Entity Type:Individual
Prefix:
First Name:JAYESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6501 PEAKE RD STE 400
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-8046
Mailing Address - Country:US
Mailing Address - Phone:478-477-0966
Mailing Address - Fax:478-254-3146
Practice Address - Street 1:6501 PEAKE RD STE 400
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-8046
Practice Address - Country:US
Practice Address - Phone:478-477-0966
Practice Address - Fax:478-254-3146
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA65164207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine