Firoz M Patka, M.D.
Individual provider Active NPI Family Medicine Physician · Louisville, GA
NPI 1821079138 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1821079138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 035499 (GA)
- Practice address
- 809 Peachtree St
Louisville, GA 30434-1449 - Phone
- (478) 625-7597
- Fax
- (478) 625-8364
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Authority of Jefferson County and the City of Louisville | Past | Accepting new patients | |
| Hospital Authority of Jefferson County and the City of Louisville | Past | Accepting new patients | |
| Ar Medical LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 035499 | GA | Yes |
Addresses
Primary practice location
809 Peachtree St
Louisville, GA 30434-1449
Mailing address
3621 Burning Tree CT.
Martinez, GA 30907
Phone (706) 868-0466
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52066052 | Other | GA | BLUE CROSS & BLUE SHIELD |
| 00000173854 | Other | GA | UNITED HEALTHCARE |
| 000505568E | Medicaid | GA | |
| 000505568D | Medicaid | GA | |
| 000505568K | Medicaid | GA | |
| 000505568L | Medicaid | GA | |
| 820136 | Other | GA | COVENTRY |
Other providers in Louisville, GA
- Erin Grace Nobles
- Ogeechee Behavioral Health Services
- Ogeechee Behavioral Health Services
- Ogeechee Behavioral Health Services
- Ogeechee Valley Emergency Physicians
- Peachtree Pharmacy and Gifts Inc
- Phillip Zachary Perkins
- James Wright Pilcher Jr.
- Janet Raines Pilcher
- James B Polhill
All providers in Louisville, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.