MEDICARE: JANOS G GUOTH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	33343	GA
2	207V00000X	Obstetrics & Gynecology Physician	ME 0067036	FL
3	207V00000X	Obstetrics & Gynecology Physician	11234	HI
4	207V00000X	Obstetrics & Gynecology Physician	14422R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285668467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANOS G GUOTH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 293
Second Line	:
City	:	BASTROP
State	:	LA
Zip	:	71221-0293
Country	:	US
Telephone Number	:	318-283-3634
Fax Number	:	318-283-3888

Provider Business Practice Location Address
First Line	:	425 S VINE ST
Second Line	:
City	:	BASTROP
State	:	LA
Zip	:	71220-4513
Country	:	US
Telephone Number	:	318-281-8555
Fax Number	:	318-281-3850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	02/07/2013

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Directions to “ JANOS G GUOTH M.D.” Practice Location

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