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Vishal Sanjay Patel

Optometrist

Eye and Vision Services Providers

201 Kimberly Way, Suite 106, Canton, GA 30114-8008

(678) 381-2020

PECOS Enrollment

This provider is enrolled in PECOS as VISHAL PATEL.

Based on the most recent information from CMS, provider Vishal Sanjay Patel is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 10 days ago.

Profile Details

Provider ID
1508133588
Provider Type
Individual
Full Name
Patel, Vishal Sanjay
Title
Dr.
Credential
O.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
11/19/2011
Last Updated
11/18/2014

Contact Information

Practice Location

201 Kimberly Way, Suite 106, Canton, GA 30114-8008

(678) 381-2020

(678) 381-2015

Mailing Location

201 Kimberly Way, Suite 106, Canton, GA 30114-8008

(678) 381-2020

(678) 381-2015

Provider Taxonomies

Code	Description	License
Code 152W00000X Primary	Description Optometrist Eye and Vision Services Providers	License OPT002647 Georgia

Vishal Sanjay Patel

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

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Description

License

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