MEDICARE: MR. JEFFREY A GUFFEY MAED, LAT, ATC

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	2255A2300X	Athletic Trainer	1121	NC

General Provider Information

NPI Number	:	1811273493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY A GUFFEY MAED, LAT, ATC

Provider Business Mailing Address
First Line	:	1632 MOUNT HOPE CHU RD
Second Line	:
City	:	MC LEANSVILLE
State	:	NC
Zip	:	27301-9243
Country	:	US
Telephone Number	:	336-207-0026
Fax Number	:	336-674-4254

Provider Business Practice Location Address
First Line	:	5700 DRAKE RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-8824
Country	:	US
Telephone Number	:	336-674-4250
Fax Number	:	336-674-4254

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

Provider Enumeration Date	:	10/27/2011
Last Update Date	:	04/26/2026

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