Individual
DR. FIROZ M PATKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
809 PEACHTREE ST, LOUISVILLE, GA 30434-1449
(478) 625-7597
(478) 625-8364
Mailing address
3621 BURNING TREE CT., MARTINEZ, GA 30907
(706) 868-0466
(706) 869-0098
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
035499
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000173854
UNITED HEALTHCARE
GA
05
—
000505568D
—
GA
05
—
000505568E
—
GA
05
—
000505568K
—
GA
05
—
000505568L
—
GA
01
—
52066052
BLUE CROSS & BLUE SHIELD
GA
01
—
820136
COVENTRY
GA
Enumeration date
11/14/2005
Last updated
07/09/2007
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