Provider Demographics
NPI:1174744817
Name:GUPTON, EMILY KATE THOMAS (DO)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:KATE THOMAS
Last Name:GUPTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-9303
Mailing Address - Country:US
Mailing Address - Phone:270-759-9200
Mailing Address - Fax:
Practice Address - Street 1:1000 S 12TH ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-9303
Practice Address - Country:US
Practice Address - Phone:270-759-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100126160Medicaid
KY000000673324OtherANTHEM
KYP400026795Medicare PIN