Provider Demographics
NPI:1730771510
Name:PATEL, JINESH (PA-C)
Entity type:Individual
Prefix:
First Name:JINESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9193 LAKESIDE ST
Mailing Address - Street 2:
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371-2657
Mailing Address - Country:US
Mailing Address - Phone:937-765-7544
Mailing Address - Fax:
Practice Address - Street 1:6096 BRANDT PIKE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-4015
Practice Address - Country:US
Practice Address - Phone:937-233-0132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant