Individual
NITESH GAUTAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7388 TURFWAY RD, FLORENCE, KY 41042-1381
(859) 287-3045
(859) 525-8806
Mailing address
3400 S BOWMAN RD APT 2007, LITTLE ROCK, AR 72211-4647
(501) 703-3540
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
61765
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/20/2020
Last updated
07/03/2026
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