Provider Demographics
NPI:1992739130
Name:PATEL, RAMESHKUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:RAMESHKUMAR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-984-2538
Mailing Address - Fax:601-815-1854
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-2538
Practice Address - Fax:601-815-1854
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS094432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS300067127OtherRAILROAD MEDICARE
MS512G700003OtherMS MEDICARE - GROUP
DG7781OtherRAILROAD GROUP
MSP01194863OtherRAILROAD MEDICARE PTAN
MN00018874Medicaid
P00607352OtherRAILROAD MEDICARE
AL158317Medicaid
MN00018874Medicaid
MS512G700003OtherMS MEDICARE - GROUP
MS300067127OtherRAILROAD MEDICARE
MS302I305434Medicare PIN
MS512I300021Medicare PIN