Healthcare Provider Details

I. General information

NPI: 1316946163
Provider Name (Legal Business Name): JAMES BRETT GUTHRIE D.C., APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 12/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 E BROADWAY ST
SPIRO OK
74959-3041
US

IV. Provider business mailing address

2000 E BROADWAY ST
SPIRO OK
74959-3041
US

V. Phone/Fax

Practice location:
  • Phone: 918-962-2439
  • Fax: 918-967-8847
Mailing address:
  • Phone: 918-962-2439
  • Fax: 918-967-8847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2510
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR0100325
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: