Provider Demographics
NPI:1558384099
Name:PATEL, PRAKASHCHANDRA B (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAKASHCHANDRA
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:13181 OLD NASHVILLE HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-4032
Practice Address - Country:US
Practice Address - Phone:615-355-5105
Practice Address - Fax:615-355-5195
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36535207P00000X
TNMD36535207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ002504Medicaid
TN3831649Medicaid
TN3831649Medicaid
TN3831649Medicaid
H76405Medicare UPIN