Individual
GEETA GUPTA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1054 MARTIN LUTHER KING DRIVE, SUITE125, CENTRALIA, IL 62801
(618) 532-1155
(618) 532-1117
Mailing address
1054 MARTIN LUTHER KING DRIVE, SUITE125, CENTRALIA, IL 62801
(618) 532-1155
(618) 532-1117
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
IL
Other
Enumeration date
04/17/2006
Last updated
07/09/2007
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