Healthcare Provider Details

I. General information

NPI: 1528258514
Provider Name (Legal Business Name): ZACHARY S GUYNN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 N SALEM RD STE 6
FAYETTEVILLE AR
72704-8803
US

IV. Provider business mailing address

PO BOX 1523
FAYETTEVILLE AR
72702-1523
US

V. Phone/Fax

Practice location:
  • Phone: 479-442-0006
  • Fax: 479-442-3038
Mailing address:
  • Phone: 479-571-6038
  • Fax: 479-582-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE-5999
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: