Individual
NILESH GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 220-6647
Mailing address
PO BOX 1867, DENTON, TX 76202-1867
(940) 384-6238
(940) 382-7680
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25258
OK
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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