Basic Information
| Provider Information | |||||||||
| NPI: | 1861448953 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | UPPAL | ||||||||
| FirstName: | UZMA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6801 DIXIE HWY | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402583913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5023151459 | ||||||||
| FaxNumber: | 5024791425 | ||||||||
| Practice Location | |||||||||
| Address1: | 1850 BLUEGRASS AVE | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402151161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5023673360 | ||||||||
| FaxNumber: | 5023673365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 07/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 36797 | KY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | 36797 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 64030943 | 05 | KY | MEDICAID | P00161159 | 01 | KY | RR MEDICARE | OTHER |