Healthcare Provider Details

I. General information

NPI: 1699769398
Provider Name (Legal Business Name): WILLIAM P GUTHINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 S GOODMAN ST
ROCHESTER NY
14607-2711
US

IV. Provider business mailing address

209 S GOODMAN ST
ROCHESTER NY
14607-2711
US

V. Phone/Fax

Practice location:
  • Phone: 585-271-2602
  • Fax: 585-244-9435
Mailing address:
  • Phone: 585-271-2602
  • Fax: 585-244-9435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number123840
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: