Provider Demographics
NPI:1083810667
Name:GUITON, TODD J (PA C, PA R)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:J
Last Name:GUITON
Suffix:
Gender:M
Credentials:PA C, PA R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ASHTON ROAD
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:LANCASTER
Mailing Address - State:LANCASHIRE
Mailing Address - Zip Code:LA1 4RP
Mailing Address - Country:GB
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ASHTON ROAD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:LANCASTER
Practice Address - State:LANCASHIRE
Practice Address - Zip Code:LA1 4RP
Practice Address - Country:GB
Practice Address - Phone:440152-458-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA1002171363A00000X
ZZ363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0227593OtherLIWA
WA8501876Medicaid
WAG8869774Medicare PIN
G15699Medicare UPIN