Provider Demographics
NPI:1891019246
Name:HOUSECALL PHYSICIAN, INC
Entity Type:Organization
Organization Name:HOUSECALL PHYSICIAN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:MOTIBHAI
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-512-0366
Mailing Address - Street 1:3326 PRESERVATION CT
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2075
Mailing Address - Country:US
Mailing Address - Phone:706-512-0366
Mailing Address - Fax:
Practice Address - Street 1:3326 PRESERVATION CT
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2075
Practice Address - Country:US
Practice Address - Phone:706-512-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA028701207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty