Organization
ASHISH K GUPTA MD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHISH K GUPTA MD (OWNER)
(502) 897-6344
Entity
Organization
Contact information
Practice address
4001 DUTCHMANS LN, STE 1H, LOUISVILLE, KY 40207-4731
(502) 897-1890
Mailing address
4001 DUTCHMANS LN, STE 1H, LOUISVILLE, KY 40207-4731
(502) 897-1890
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
35610
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000598746
ANTHEM
KY
01
—
50021989
PASSPORT
KY
05
—
7100061560
—
KY
Enumeration date
11/11/2008
Last updated
04/11/2012
Update your record
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