MEDICARE: JOSEPH JAY GUTH 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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	35.064900	OH
2	207X00000X	Orthopaedic Surgery Physician	35.064900	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	H383664	OTHER	OH	MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1417918038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH JAY GUTH M.D.

Provider Business Mailing Address
First Line	:	1040 DELAWARE AVE
Second Line	:
City	:	MARION
State	:	OH
Zip	:	43302-6416
Country	:	US
Telephone Number	:	740-383-7936
Fax Number	:	740-375-8174

Provider Business Practice Location Address
First Line	:	24 MORRIS RD
Second Line	:	SUITE 2
City	:	SHELBY
State	:	OH
Zip	:	44875-1170
Country	:	US
Telephone Number	:	419-347-4177
Fax Number	:

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	12/15/2021

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