Organization
JEFFERSON COUNTY INTERNAL MEDICINE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHUTOSH H. PATEL M.D. (PHYSICIAN)
(636) 937-1528
Entity
Organization
Contact information
Practice address
1455 US HIGHWAY 61, STE C, FESTUS, MO 63028-4109
(636) 937-1528
(636) 933-2885
Mailing address
1455 US HIGHWAY 61, STE C, FESTUS, MO 63028-4109
(636) 937-1528
(636) 933-2885
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
106434
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207692401
—
MO
Enumeration date
05/21/2007
Last updated
02/03/2012
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