Provider Demographics
NPI:1881797827
Name:JAIN, RICHA GUPTA (MD)
Entity type:Individual
Prefix:
First Name:RICHA
Middle Name:GUPTA
Last Name:JAIN
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:5200 COMMERCE CROSSINGS DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-2182
Mailing Address - Country:US
Mailing Address - Phone:502-253-4910
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:2400 EASTPOINT PKWY STE 550
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223
Practice Address - Country:US
Practice Address - Phone:502-253-6630
Practice Address - Fax:502-253-6639
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2020-12-07
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Provider Licenses
StateLicense IDTaxonomies
KY40184207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00546068Medicare PIN