Organization
OLD HENRY FAMILY PRACTICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHA GUPTA MD (OWNER)
(502) 295-8141
Entity
Organization
Contact information
Practice address
2503 BUSH RIDGE DR, SUITE A, LOUISVILLE, KY 40245-5885
(502) 245-2701
(502) 290-2839
Mailing address
2503 BUSH RIDGE DR, SUITE A, LOUISVILLE, KY 40245-5885
(502) 245-2701
(502) 290-2839
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
10/14/2009
Last updated
09/29/2011
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