Provider Demographics
NPI:1205044427
Name:PATEL, JAMIE (DO)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 674721
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4721
Mailing Address - Country:US
Mailing Address - Phone:641-787-3161
Mailing Address - Fax:641-787-3165
Practice Address - Street 1:300 N 4TH AVE E STE D
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3155
Practice Address - Country:US
Practice Address - Phone:641-787-3161
Practice Address - Fax:641-787-3165
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-03681208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1205044427Medicaid
IAP01157313OtherRR MEDICARE
IA1205044427Medicaid