Individual
DR. SANJIV GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 STATE HIGHWAY 1947, GRAYSON, KY 41143
(606) 474-2200
(606) 474-2205
Mailing address
PO BOX 1620, 300 STATE HWY 1947, GRAYSON, KY 41143
(606) 474-2200
(606) 474-2205
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32686
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2016446
—
OH
05
—
64326861
—
KY
Enumeration date
08/25/2006
Last updated
09/07/2012
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