Individual
JAGDISH R PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2025 VIRGINIA AVE STE C, CONNERSVILLE, IN 47331-2921
(765) 827-0876
(765) 825-6999
Mailing address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331
(765) 827-7795
(765) 827-7796
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
71000824A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000080791
BLUE CROSS
IN
05
—
100114680
—
IN
Enumeration date
03/18/2006
Last updated
07/08/2007
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