Provider Demographics
NPI:1568529006
Name:PATEL, PRAGNESH A (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAGNESH
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:120 HOSPITAL DR STE 260
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-5283
Mailing Address - Country:US
Mailing Address - Phone:319-331-8323
Mailing Address - Fax:423-839-2424
Practice Address - Street 1:120 HOSPITAL DR STE 260
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-5283
Practice Address - Country:US
Practice Address - Phone:423-839-2525
Practice Address - Fax:423-839-2424
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000045390207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN114680CW2Medicare Oscar/Certification