Provider Demographics
NPI:1033210596
Name:GUARNASCHELLI, JOHN JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:GUARNASCHELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:234 E GRAY ST
Practice Address - Street 2:SUITE 768
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1901
Practice Address - Country:US
Practice Address - Phone:502-584-4121
Practice Address - Fax:502-584-6626
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY14746207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY119046OtherSIHO - NNIKY
1048759OtherPASSPORT PROVIDER #
KY000052155VOtherHUMANA - NNIKY
000000045440OtherANTHEM PROVIDER #
KY000000674359OtherANTHEM - NNIKY
IN100383680OtherINDIANA MEDICAID
KY64147465Medicaid
KY50029962OtherPASSPORT & PASSPORT ADVANTAGE - NNIKY
KY2529982OtherCIGNA - NNIKY
KY1275902Medicare PIN
KY000052155VOtherHUMANA - NNIKY
KYP00878866Medicare PIN
C73557Medicare UPIN