Provider Demographics
NPI:1396498465
Name:PATEL, PRATIK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PRATIK
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 GRAY HAWK TRL
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6286
Mailing Address - Country:US
Mailing Address - Phone:931-241-2324
Mailing Address - Fax:
Practice Address - Street 1:315 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1507
Practice Address - Country:US
Practice Address - Phone:615-792-2269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-30
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist