Healthcare Provider Details
I. General information
NPI: 1801996392
Provider Name (Legal Business Name): MICHAEL L GUYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/24/2006
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9755 W STATE HIGHWAY 22
RATCLIFF AR
72951
US
IV. Provider business mailing address
PO BOX 130
RATCLIFF AR
72951-0130
US
V. Phone/Fax
- Phone: 479-635-5300
- Fax: 479-635-2010
- Phone: 479-635-5300
- Fax: 479-635-2010
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | E1081 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: