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General NPI Number Information
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NPI Number | 1629098660
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Entity Type | Individual
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Provider Name | GERARD G GUERIN DPM
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 02/07/2018
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Provider Practice Location Address
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Address Line | 5787 S HAMPTON RD
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City | DALLAS
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State | TX
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Zip | 75232-2255
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Country | US
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Telephone | 601-362-3158
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Fax | 601-987-8800
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Provider Business Mailing Address
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Address Line | 47026 SCOTT DR
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City | HAMMOND
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State | LA
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Zip | 70401-7323
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Country | US
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Telephone | 601-362-3158
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Fax | 601-987-8800
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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 | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 80070
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License Number State | MS
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