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Contact Information

VIVEK K GUPTA, MD
6002 PROFESSIONAL PARKWAY
SUITE 100
DOUGLASVILLE, GA30134
 Phone: 770-949-4200
 Fax: 770-949-5553
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for VIVEK K GUPTA · (Male)

NPI Number 1881612133
Status Active
Credentials MD
Entity Individual
Enumeration date 07/17/2006
Last updated 07/14/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 052734
  • GA Medicaid 003379537A
  • GA Medicaid 003379537B
  • Other 7157520 AETNA HMO
  • Other 7157520 AETNA PPO
  • Other 072044 BLUE
  • Other 5418507001 CIGNA
  • Other P00107542 RAILROAD MEDICARE
  • Other 323384 WELLCARE
Hospital affiliation(s)
  • WELLSTAR COBB HOSPITAL - (Acute Care)
    3950 AUSTELL RD
    AUSTELL, GA 30106
  • WELLSTAR DOUGLAS HOSPITAL - (Acute Care)
    8954 HOSPITAL DRIVE
    DOUGLASVILLE, GA 30134
  • WELLSTAR KENNESTONE HOSPITAL - (Acute Care)
    677 CHURCH STREET
    MARIETTA, GA 30060
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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