Healthcare Provider Details

I. General information

NPI: 1922112168
Provider Name (Legal Business Name): CEDRIC GUYTON PHARMD., MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAN XAVIER INDIAN HEALTH CENTER 7900 S. J STOCK RD
TUCSON AZ
85746
US

IV. Provider business mailing address

4990 E. CHICKWEED DR.
TUCSON AZ
85706
US

V. Phone/Fax

Practice location:
  • Phone: 520-295-2550
  • Fax:
Mailing address:
  • Phone: 928-386-1688
  • Fax: 520-295-2644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPS33454
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: