Provider Demographics
NPI:1306819792
Name:GUTH, ROBERT WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:GUTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4777 ANDREW JACKSON PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1356
Mailing Address - Country:US
Mailing Address - Phone:615-889-0134
Mailing Address - Fax:615-889-0135
Practice Address - Street 1:4777 ANDREW JACKSON PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1356
Practice Address - Country:US
Practice Address - Phone:615-889-0134
Practice Address - Fax:615-889-0135
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD18597207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN110086400Medicare PIN
TNA99493Medicare UPIN
TNCM6293Medicare PIN
TN3031207Medicare ID - Type Unspecified