Provider Demographics
NPI:1073509592
Name:GUPTA, ASHIMA KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHIMA
Middle Name:KUMAR
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1279 CHEROKEE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-2204
Mailing Address - Country:US
Mailing Address - Phone:202-494-8423
Mailing Address - Fax:
Practice Address - Street 1:4940 HAZELWOOD AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-1270
Practice Address - Country:US
Practice Address - Phone:502-368-3937
Practice Address - Fax:502-368-0231
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39832207WX0110X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100267370Medicaid
KY7100267370Medicaid