Healthcare Provider Details

I. General information

NPI: 1205014040
Provider Name (Legal Business Name): ALLEN C GUEHL DPM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 N MAIN ST
DAYTON OH
45415-2854
US

IV. Provider business mailing address

1836 ASH MEADOW CT
XENIA OH
45385-9595
US

V. Phone/Fax

Practice location:
  • Phone: 937-252-9653
  • Fax: 866-304-2735
Mailing address:
  • Phone: 937-252-9653
  • Fax: 866-304-2735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36-003114
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number36003114
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number36003114
License Number StateOH

VIII. Authorized Official

Name: DR. ALLEN C GUEHL
Title or Position: OWNER
Credential: DPM
Phone: 937-252-9653