Provider Demographics
NPI:1588681159
Name:PATEL, DEEPESH RUBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEPESH
Middle Name:RUBIN
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15550 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-6504
Mailing Address - Country:US
Mailing Address - Phone:225-224-8690
Mailing Address - Fax:225-615-7704
Practice Address - Street 1:2840 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-2721
Practice Address - Country:US
Practice Address - Phone:225-224-2402
Practice Address - Fax:225-367-4938
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA025128207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1421723Medicaid
LA4F6936629Medicare PIN
I01385Medicare UPIN