Provider Demographics
NPI:1144402439
Name:EUGENE F GUERRE JR MD
Entity Type:Organization
Organization Name:EUGENE F GUERRE JR MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:GUERRE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:352-597-7700
Mailing Address - Street 1:7005 NIGHTWALKER RD
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-6349
Mailing Address - Country:US
Mailing Address - Phone:352-597-7700
Mailing Address - Fax:352-597-9951
Practice Address - Street 1:7005 NIGHTWALKER RD
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34613-6349
Practice Address - Country:US
Practice Address - Phone:352-597-7700
Practice Address - Fax:352-597-9951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0072863207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1257Medicare PIN