Individual
EKTA THAKOR PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-3157
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-3157
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
003078
GA
207Q00000X
Family Medicine Physician
Primary
994188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A139064
STATE MEDICAL LICENSE
CA
Enumeration date
06/25/2008
Last updated
03/07/2023
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