MEDICARE: KEITH BRYAN GUESS PA

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	363A00000X	Physician Assistant	085-001376	IL
2	363A00000X	Physician Assistant	001170	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	421527584	OTHER	TRI-CARE
3	42152758406	OTHER	JOHN DEERE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841293354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH BRYAN GUESS PA

Provider Business Mailing Address
First Line	:	200 HAWKINS DR
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1009
Country	:	US
Telephone Number	:	319-335-8370
Fax Number	:	319-335-7247

Provider Business Practice Location Address
First Line	:	4189 WESTLAWN S
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1100
Country	:	US
Telephone Number	:	319-335-8370
Fax Number	:	319-335-7247

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	03/23/2023

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Directions to “ KEITH BRYAN GUESS PA” Practice Location

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