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Organization

ANIL GUPTA M D

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANIL GUPTA M.D. (OWNER)
(618) 281-7151
Entity
Organization

Contact information

Practice address
421 S. MAIN, COLUMBIA, IL 62236
(618) 281-7151
(618) 281-6680
Mailing address
PO BOX 522, 421 SOUTH MAIN STREET, COLUMBIA, IL 62236
(618) 281-7151
(618) 281-6680

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036086275
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036086275
IL
Enumeration date
09/13/2006
Last updated
04/21/2025
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