Individual
AAYUSH GAUTAM PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5601
(601) 984-6665
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5601
(601) 984-6665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T-3832
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2019
Last updated
08/22/2022
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