Provider Demographics
NPI:1922605294
Name:DIGESTIVE HEALTH CLINIC, PLLC
Entity Type:Organization
Organization Name:DIGESTIVE HEALTH CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAGDISH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-229-7172
Mailing Address - Street 1:13128 N 94TH DR STE 201
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4253
Mailing Address - Country:US
Mailing Address - Phone:623-209-4227
Mailing Address - Fax:623-209-7227
Practice Address - Street 1:13128 N 94TH DR STE 201
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4253
Practice Address - Country:US
Practice Address - Phone:623-209-7227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty