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General NPI Number Information
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NPI Number | 1487727731
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Entity Type | Individual
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Provider Name | ISHAN BHATTACHARYA MD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 3590 W 9000 S STE 120
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City | WEST JORDAN
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State | UT
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Zip | 84088-8858
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Country | US
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Telephone | 801-208-1075
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Fax | 385-351-6735
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Provider Business Mailing Address
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Address Line | 1911 COBBLESTONE LN APT 119
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City | MILAN
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State | IL
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Zip | 61264-2614
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Country | US
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Telephone | 443-465-2403
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036068763
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 14199050-1235
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD-48413
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License Number State | IA
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