Provider Demographics
NPI:1740717669
Name:MISTRY, KALPESH (MD)
Entity type:Individual
Prefix:DR
First Name:KALPESH
Middle Name:
Last Name:MISTRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-6820
Mailing Address - Country:US
Mailing Address - Phone:706-282-4200
Mailing Address - Fax:
Practice Address - Street 1:115 ROCK QUARRY RD
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-8734
Practice Address - Country:US
Practice Address - Phone:706-282-5815
Practice Address - Fax:706-898-5716
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA83153207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine