Individual
ANIL KUMAR GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3312 N OAK ST EXT BLDG D, VALDOSTA, GA 31605-1066
(229) 244-2030
(229) 244-2038
Mailing address
3312 N OAK ST EXT BLDG D, VALDOSTA, GA 31605-1066
(229) 244-2030
(229) 244-2038
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
045487
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000934975J
—
GA
Enumeration date
06/28/2006
Last updated
09/08/2020
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