Organization
JACKSON ORTHOPEDIC AND SPINE CLINIC
Active
Organization
JACKSON ORTHOPEDIC AND SPINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIRIRAJ GUPTA MD (OWNER)
(606) 568-9921
Entity
Organization
Contact information
Practice address
832 HIGHWAY 15 N, JACKSON, KY 41339-8284
(606) 568-9921
(330) 773-3698
Mailing address
832 HIGHWAY 15 N, JACKSON, KY 41339-8284
(606) 568-9921
(330) 773-3698
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
42230
KY
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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