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General NPI Number Information
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NPI Number | 1073470514
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Entity Type | Individual
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Provider Name | GUY LANDON MACE
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Gender | Male
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1542 SPRING VALLEY DR
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City | HUNTINGTON
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State | WV
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Zip | 25704-9501
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Country | US
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Telephone | 304-696-6035
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Fax |
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Provider Business Mailing Address
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Address Line | 5135 COAKLEY RD NW
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City | CARROLL
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State | OH
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Zip | 43112-9536
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Country | US
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Telephone | 740-503-9838
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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