Provider Demographics
NPI:1861666125
Name:PATELS' MEDICAL-SURGICAL PRACTICE, P.C.
Entity Type:Organization
Organization Name:PATELS' MEDICAL-SURGICAL PRACTICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHOBHA
Authorized Official - Middle Name:N
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-886-8239
Mailing Address - Street 1:6522 E CARONDELET DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2200
Mailing Address - Country:US
Mailing Address - Phone:520-886-8239
Mailing Address - Fax:520-885-1705
Practice Address - Street 1:6522 E CARONDELET DR
Practice Address - Street 2:SUITE B
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2200
Practice Address - Country:US
Practice Address - Phone:520-886-8239
Practice Address - Fax:520-885-1705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ121928Medicare PIN