Organization
OWENSBORO MEDICAL INTERNISTS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NITYANAND D GUPTA MD (OWNER)
(270) 240-5696
Entity
Organization
Contact information
Practice address
2816 VEACH RD STE 3-306, OWENSBORO, KY 42303-6295
(270) 240-5696
(270) 240-5697
Mailing address
2816 VEACH RD STE 306, OWENSBORO, KY 42303-6297
(270) 240-5696
(270) 240-5697
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100112820
—
KY
Enumeration date
08/14/2009
Last updated
01/07/2014
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