MEDICARE: DR. JUSTIN PAUL GUSCHING D.O.

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	208600000X	Surgery Physician	77750	GA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	208600000X	Surgery Physician	34.011647	OH

General Provider Information

NPI Number	:	1386919934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN PAUL GUSCHING D.O.

Provider Business Mailing Address
First Line	:	210 CITY GREEN WAY APT 304
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37405-1475
Country	:	US
Telephone Number	:	419-733-9729
Fax Number	:

Provider Business Practice Location Address
First Line	:	1405 COWART ST STE 201
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37408-1127
Country	:	US
Telephone Number	:	423-758-8636
Fax Number	:

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

Provider Enumeration Date	:	03/15/2012
Last Update Date	:	07/21/2022

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