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General NPI Number Information
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NPI Number | 1932133824
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Entity Type | Individual
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Provider Name | HARALD GUTGSELL MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 222 S SUMMIT AVE 3
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City | PRESCOTT
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State | AZ
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Zip | 86303-3780
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Country | US
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Telephone | 928-708-9788
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Fax | 928-708-9789
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Provider Business Mailing Address
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Address Line | 1345 COYOTE RD
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City | PRESCOTT
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State | AZ
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Zip | 86303-5334
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Country | US
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Telephone | 928-717-9796
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Fax | 928-708-9789
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 24589
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License Number State | AZ
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