Healthcare Provider Details
I. General information
NPI: 1023239720
Provider Name (Legal Business Name): PAULA M GUINNIP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/01/2007
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 HARRIS CIR STE 202
TAHLEQUAH OK
74464-8849
US
IV. Provider business mailing address
PO BOX 415
TAHLEQUAH OK
74465-0415
US
V. Phone/Fax
- Phone: 918-485-0068
- Fax: 918-485-0069
- Phone: 918-485-0068
- Fax: 918-485-0069
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 30170 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 2016030313 |
| License Number State | MO |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 30170 |
| License Number State | OK |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: