Healthcare Provider Details

I. General information

NPI: 1639361678
Provider Name (Legal Business Name): LOUIS K GUINN MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E PUSHMATAHA ST
BUTLER AL
36904-2533
US

IV. Provider business mailing address

315 E PUSHMATAHA ST
BUTLER AL
36904-2533
US

V. Phone/Fax

Practice location:
  • Phone: 205-459-4499
  • Fax: 205-459-5348
Mailing address:
  • Phone: 205-459-4499
  • Fax: 205-459-5348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13769
License Number StateAL

VIII. Authorized Official

Name: DR. LOUIS KEITH GUINN
Title or Position: OWNER
Credential: MD
Phone: 205-459-4499