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General NPI Number Information
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NPI Number | 1548331408
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR CONSULTANTS PSC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 815 E PARRISH AVE SUITE 330
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City | OWENSBORO
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State | KY
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Zip | 42303-3222
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Country | US
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Telephone | 270-926-2998
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 98
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City | OWENSBORO
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State | KY
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Zip | 42302-0098
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | M.D.
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Name | MUKESH GUPTA
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Credential |
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Telephone | 270-926-2998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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