Provider Demographics
NPI:1386097301
Name:PATEL, KESHA S (OD)
Entity type:Individual
Prefix:DR
First Name:KESHA
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:9200 STONY POINT PKWY STE 195B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1973
Mailing Address - Country:US
Mailing Address - Phone:678-849-4955
Mailing Address - Fax:
Practice Address - Street 1:400 WESTHAMPTON STA
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3330
Practice Address - Country:US
Practice Address - Phone:804-287-4200
Practice Address - Fax:804-287-4210
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002510152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist