Provider Demographics
NPI:1053372094
Name:RAHUL D PATIL MD PSC
Entity type:Organization
Organization Name:RAHUL D PATIL MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-532-5141
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-0098
Mailing Address - Country:US
Mailing Address - Phone:740-532-5141
Mailing Address - Fax:740-532-6737
Practice Address - Street 1:2412 S 6TH ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-2631
Practice Address - Country:US
Practice Address - Phone:740-532-5141
Practice Address - Fax:740-532-6737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35068808207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2525182Medicaid
KY65942179Medicaid
DC3997OtherRAILROAD MEDICARE
KY9362Medicare PIN
OH9349351Medicare PIN