Provider Demographics
NPI:1104984400
Name:PATEL, JAYKUMAR C (MD)
Entity type:Individual
Prefix:DR
First Name:JAYKUMAR
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9 BRIGHTON PL
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1171
Mailing Address - Country:US
Mailing Address - Phone:215-785-9890
Mailing Address - Fax:215-785-9987
Practice Address - Street 1:501 BATH RD
Practice Address - Street 2:SUITE 508
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-3101
Practice Address - Country:US
Practice Address - Phone:215-785-9890
Practice Address - Fax:215-785-9987
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031132E204E00000X, 208200000X, 2082S0105X, 208600000X, 2086S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000080208OtherHIGHMARK BLUE SHIELD
PA07341843Medicaid
PA00524710000OtherINDEPEDENCE BLUE CROSS
PA240001232OtherRAILROAD MEDICARE
PA240001232OtherRAILROAD MEDICARE
PAAP2183109OtherDEA NUMBER
PA07341843Medicaid