Provider Demographics
NPI:1487057139
Name:PATEL, JIGNESH
Entity type:Individual
Prefix:
First Name:JIGNESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 CAPITAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-2676
Mailing Address - Country:US
Mailing Address - Phone:269-339-0121
Mailing Address - Fax:269-339-0120
Practice Address - Street 1:629 CAPITAL AVE SW
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-2676
Practice Address - Country:US
Practice Address - Phone:269-339-0121
Practice Address - Fax:269-339-0120
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302041367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist