Healthcare Provider Details

I. General information

NPI: 1952737066
Provider Name (Legal Business Name): EMILY JANE GUYER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 09/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 WOLCOTT DR
COLUMBIA MO
65202-1902
US

IV. Provider business mailing address

2015 WOLCOTT DR
COLUMBIA MO
65202-1902
US

V. Phone/Fax

Practice location:
  • Phone: 573-442-4637
  • Fax:
Mailing address:
  • Phone: 573-442-4637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number27036
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: