Healthcare Provider Details

I. General information

NPI: 1508827692
Provider Name (Legal Business Name): DOUGLAS M GUY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 N 78TH ST
OMAHA NE
68114-3640
US

IV. Provider business mailing address

13417 BOYD ST
OMAHA NE
68164-6004
US

V. Phone/Fax

Practice location:
  • Phone: 402-315-3788
  • Fax: 402-614-1033
Mailing address:
  • Phone: 402-616-4811
  • Fax: 402-702-1544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number16729
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: