Individual
RAKESHKUMAR PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MBA
Contact information
Practice address
1025 EXECUTIVE PARK BLVD, KINGSPORT, TN 37660-4620
(423) 830-8110
(423) 473-1102
Mailing address
805 QUAIL RIDGE CT, ELIZABETHTON, TN 37643-5064
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD41317
TN
2084P0800X
Psychiatry Physician
0101238677
VA
2084P0800X
Psychiatry Physician
Primary
MD41317
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013998004
—
VA
01
—
81127000
MAGELLAN
TN
01
—
P00877921
RR MEDICARE
—
05
—
Q004992
—
TN
05
—
Q029152
—
TN
Enumeration date
11/08/2005
Last updated
04/30/2025
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