Provider Demographics
NPI:1043558620
Name:GUTKOWSKI, S LEONARD (MD)
Entity Type:Individual
Prefix:DR
First Name:S
Middle Name:LEONARD
Last Name:GUTKOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STANLEY
Other - Middle Name:LEONARD
Other - Last Name:GUTKOWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5970 WEDGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-8406
Mailing Address - Country:US
Mailing Address - Phone:513-480-0099
Mailing Address - Fax:
Practice Address - Street 1:5970 WEDGWOOD DR
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152-8406
Practice Address - Country:US
Practice Address - Phone:513-480-0099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020356E207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology