Basic Information
| Provider Information | |||||||||
| NPI: | 1760826887 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | NAVAL | ||||||||
| MiddleName: | HASMUKH | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10001 LILE DR | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722056217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5015520500 | ||||||||
| FaxNumber: | 5013201682 | ||||||||
| Practice Location | |||||||||
| Address1: | 10001 LILE DR | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722056217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012278000 | ||||||||
| FaxNumber: | 5012215872 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2013 | ||||||||
| LastUpdateDate: | 10/06/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213EP1101X | 267 | AR | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Primary Podiatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 216563717 | 05 | AR | MEDICAID | 688352 | 01 | AR | MEDICARE ID# FOR CHI ST. VINCENT LITTLE ROCK DIAGNOSTIC CLINIC | OTHER |