Provider Demographics
NPI:1023204435
Name:GI ENDOSCOPY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:GI ENDOSCOPY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANAND
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-893-7744
Mailing Address - Street 1:6305 INNISBROOK DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-9285
Mailing Address - Country:US
Mailing Address - Phone:502-893-7744
Mailing Address - Fax:502-893-7741
Practice Address - Street 1:6305 INNISBROOK DR
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-9285
Practice Address - Country:US
Practice Address - Phone:502-893-7744
Practice Address - Fax:502-893-7741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical