Healthcare Provider Details

I. General information

NPI: 1639225634
Provider Name (Legal Business Name): WILLIAM A GUYETTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 10/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 HOSPITAL DR
SALEM KY
42078-8043
US

IV. Provider business mailing address

PO BOX 9150
PADUCAH KY
42002-9150
US

V. Phone/Fax

Practice location:
  • Phone: 270-988-2299
  • Fax: 270-988-3900
Mailing address:
  • Phone: 270-744-9600
  • Fax: 270-744-0834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number22109
License Number StateKY

VIII. Authorized Official

Name: WILLIAM A GUYETTE
Title or Position: PHYSICIAN
Credential: MD
Phone: 270-988-2299