Healthcare Provider Details

I. General information

NPI: 1497790414
Provider Name (Legal Business Name): JAMES P GUTHEIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4704 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70508-6908
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-5500
  • Fax: 225-765-5543
Mailing address:
  • Phone: 225-765-5500
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD219632
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberL6924
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number04-41342
License Number StateKS
# 4
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number343126
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: