Provider Demographics
NPI:1730294844
Name:PATEL, JAGDISH B (MD)
Entity Type:Individual
Prefix:DR
First Name:JAGDISH
Middle Name:B
Last Name:PATEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:18715 N REEMS RD
Mailing Address - Street 2:STE 140
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8643
Mailing Address - Country:US
Mailing Address - Phone:623-209-7227
Mailing Address - Fax:623-209-7301
Practice Address - Street 1:13634 N 93RD AVE
Practice Address - Street 2:STE 200
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4914
Practice Address - Country:US
Practice Address - Phone:623-209-7227
Practice Address - Fax:623-209-7301
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2017-01-06
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Provider Licenses
StateLicense IDTaxonomies
AZ15420174400000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD37421Medicare UPIN