Provider Demographics
NPI:1194916213
Name:GUPTA, GIRIRAJ (MD)
Entity type:Individual
Prefix:
First Name:GIRIRAJ
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:509 MEMORIAL DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-6195
Mailing Address - Country:US
Mailing Address - Phone:606-598-5104
Mailing Address - Fax:606-598-0983
Practice Address - Street 1:120 MARIE LANGDON DR
Practice Address - Street 2:SUITE 1
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-6352
Practice Address - Country:US
Practice Address - Phone:606-598-4529
Practice Address - Fax:606-599-2529
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2015-10-13
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Provider Licenses
StateLicense IDTaxonomies
KY42230207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery