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Organization

GAFFNEY UROLOGY PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VENKATAIAH GUTTA MD (PHYSICIAN)
(864) 487-5124
Entity
Organization

Contact information

Practice address
140 4TH AVE, GAFFNEY, SC 29340-4726
(864) 487-5124
(864) 487-5125
Mailing address
PO BOX 4, GAFFNEY, SC 29342-0004
(864) 487-5124
(864) 487-5125

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
09480
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP3698
SC
Enumeration date
01/30/2007
Last updated
10/11/2007
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