Organization
GRAYSON HEALTH PARK
Active
Other names
TriState Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJIV GUPTA M.D. (PHYSICIAN)
(606) 474-2200
Entity
Organization
Contact information
Practice address
2020 W HEARTHSTONE CT, ASHLAND, KY 41102-9445
(606) 923-2819
Mailing address
2020 W HEARTHSTONE CT, ASHLAND, KY 41102-9445
(606) 923-2819
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
TC494
KY
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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