Organization
KENTUCKIANA HEART & VASCULAR SPECIALISTS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUKESH GUPTA MD (PRESIDENT OF CORPORATION)
(270) 926-2998
Entity
Organization
Contact information
Practice address
815 EAST PARRISH AVENUE, SUITE 330, OWENSBORO, KY 42303
(270) 926-2998
(270) 926-1181
Mailing address
815 EAST PARRISH AVENUE, SUITE 330, OWENSBORO, KY 42303
(270) 926-2998
(270) 926-1181
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65909848
—
KY
Enumeration date
07/11/2006
Last updated
08/22/2020
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